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Haemospermia: how to proceed?

T Creagh1, A McNamara, T E McDermott

  • 1Department of Urology, Meath Hospital, Dublin.

Irish Journal of Medical Science
|May 1, 1993
PubMed
Summary
This summary is machine-generated.

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Haemospermia, or blood in semen, rarely indicates cancer. Infection is the most frequent cause, and urine microscopy is the best diagnostic test, not cystoscopy.

Area of Science:

  • Urology
  • Andrology
  • Diagnostic Medicine

Background:

  • Haemospermia, characterized by blood in the ejaculate, is a concerning symptom for many men.
  • The clinical significance and appropriate diagnostic pathways for haemospermia require clarification.
  • Distinguishing benign causes from serious underlying pathology is crucial for patient management.

Purpose of the Study:

  • To evaluate the association between haemospermia and serious underlying diseases, particularly malignancy.
  • To determine the most effective diagnostic investigations for patients presenting with haemospermia.
  • To assess the utility of standard urological investigations versus alternative methods.

Main Methods:

  • Retrospective review of medical records for 44 male patients experiencing haemospermia.

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  • Analysis of diagnostic findings, including urine tests, imaging, and cystoscopy.
  • Correlation of symptoms with identified causes, focusing on infection and malignancy.

    • Main Results:

    • No evidence of malignancy was found in the reviewed cases of haemospermia.
    • Infection emerged as the most common etiological factor.
    • Standard investigations like midstream urine analysis, intravenous pyelography, and cystoscopy proved unhelpful in diagnosis.

    Conclusions:

    • Haemospermia is infrequently associated with malignancy, alleviating patient anxiety.
    • Microscopy and culture of a first-stream urine specimen or expressed prostatic secretions are the preferred diagnostic methods.
    • Cystoscopy should be reserved for cases of recurrent haemospermia to optimize diagnostic yield and resource allocation.