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Hematospermia-a Symptom With Many Possible Causes.

Michael J Mathers¹, Stefan Degener, Herbert Sperling

¹Joint Urological Practice Remscheid, PandaMED, Cooperative Practice of the Department of Urology and Pediatric Urology, Helios Hospital Group Wuppertal, University of Witten/Herdecke; Department of Urology and Pediatric Urology, Wuppertal Hospital, Helios Hospital Group Wuppertal, University of Witten/Herdecke; Department of Urology, Maria Hilf Hospital Group, Mönchengladbach.

Deutsches Arzteblatt International

|April 7, 2017

Summary

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Hematospermia, or blood in ejaculate, is common in men under 40 and usually benign. Evaluation is recommended, with further tests like imaging studies to rule out serious causes, especially in older men or with recurrent episodes.

Area of Science:

Urology
Andrology

Background:

Hematospermia (blood in ejaculate) is a concerning symptom with various potential causes.
While often benign and common in men under 40, it warrants diagnostic evaluation.
Prevalence data for hematospermia is limited.

Purpose of the Study:

To review and present a diagnostic algorithm for hematospermia.
To identify common causes and guide evaluation strategies.
To emphasize the importance of further investigations for specific patient groups.

Main Methods:

Literature review using PubMed.
Keywords included "hematospermia," "hemospermia," "ejaculation," "male semen," and "transrectal ultrasound."
Synthesis of findings to create a diagnostic approach.

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Main Results:

Iatrogenic trauma (e.g., post-biopsy) is the most frequent cause of hematospermia.
Urogenital infections are the second leading cause.
Other considerations include prostate pathology, systemic conditions like hypertension, and hematologic disorders.

Conclusions:

Imaging studies are valuable for detecting or excluding potential causes, particularly malignancies.
Treatment for hematospermia is determined by the identified underlying cause.
A thorough history, physical exam, and urinalysis are crucial initial steps.