Abstract Hematospermia is a distressing disorder in sexually active men resulting in great concern to the patient. We report an unusual case of hematospermia with an atypical presentation, involving a 54-year-old man presented with acute urinary retention after sexual intercourse. Although the causes are widely known, arteriovenous malformation as the cause of this disorder has not much been reported in the literature. Transcatheter embolization of internal pudendal artery is a promising option for hematospermia caused by arterial fistula or bleeding.
Hemospermia

The therapeutic efficacy and significance of intraprostatic fosfomycin injection in treating patients with chronic prostatitis were reviewed. During the last 6 years, 350 patients were treated with intraprostatic fosfomycin injection for chronic prostatitis, and among them, 218 patients who could be followed up at least for 3 months were analysed. As for chronic prostatitis, when a patient's WBC count of EPS per high power field remains invariable below 15 for at least 3 months, he is said to be cured. Intraprostatic injection was performed once or twice in all patients and 153 (70.2%) cases were responsive to this treatment. But eleven patients recurred immediately within 3 months after the response. Therefore, final cure rate reached 65.1% (142/218): Adverse effects were rare, if any, they were just trivial symptoms such as mild suprapubic pain or discomfort, transient hematuria and hemospermia. These facts demonstrate that intraprostatic fosfomycin injection has much advantage in patients with chronic prostatitis as treatment modality compared with ordinary method.
Fosfomycin* ; Hematuria ; Hemospermia ; Humans ; Prostatitis*

Hemospermia refers to the macroscopic presence of blood in semen, which may be associated with male genital tract, lower urinary tract and systemic diseases. Hemospermia is prevalent in young males. It is mostly a benign lesion and self-limited symptom, requiring only basic investigations and simple management. But in a few patients, it may be the primary symptom of urogenital malignancy. Therefore in patients older than 40 years, or in those with persistent or recurrent hemospermia, further investigation should be conducted by imaging and endoscopic examinations to make definite etiological diagnosis and give corresponding treatment. This article reviews the etiology, initial diagnostic workup, imaging techniques and endoscopic examination of hemospermia, and summeries its management.
Hemospermia ; diagnosis ; etiology ; therapy ; Humans ; Male

Ejaculatory Ducts ; Hemospermia ; Humans ; Male ; Seminal Vesicles

Hemospermia is a common urologic problem that can be caused by diverse pathologic entities, including inflammatory and neoplastic disorders of the seminal tract. Transrectal ultrasonography provides excellent anatomic detail of pathologic changes in the seminal vesicle and ejaculatory duct. Morphological change of the seminal tract of patient with hemospermia was determined by means or transrectal sonography on 16 patients. The 14 patients (88%) had positive sonographic findings, Abnormalities detected included 5 cases of seminal vesicle stones, 2 cases of dilatated seminal vesicles, 3 cases of ejaculatory duct stones. 2 cases of ejaculatory duct cysts, 1 case of seminal vesicle stone and ejaculatory duct stone, 1 case of Mullerian duct cyst. Our result indicate that transrectal ultrasound is effective in studing in patient with organic hemospermia.
Ejaculatory Ducts ; Hemospermia* ; Humans ; Male ; Seminal Vesicles ; Ultrasonography*

PURPOSE: We evaluated the therapeutic efficacy of finasteride in the treatment of hemospermia, especially in prostatitis-related hemospermia. MATERIALS AND METHODS: Among the patients who visited our urologic department due to hemospermia from Jan 2000 to Oct 2003, 46 patients enrolled in the study. Semen analysis, expressed prostatic secretion, and transrectal ultrasonography were performed for all patients, and we determined whether or not the hemospermia was caused by inflammatory chronic non-bacterial prostatitis. We sorted all the subjects into 2 groups by the use of finasteride or not. We sub-divided the 2 groups by the presence or absence of prostatitis. In each of the 4 groups, the results were compared. Results were also recalculated after excluding sonographically abnormal cases. RESULTS: In the 35 finasteride-treated patients, the prostatitis group showed a 75% (12/16) success rate whereas the non-prostatitis group showed 31.6% (6/19) success. This difference was statistically significant (p=0.01). In the 11 non-finasteride patients, there was no difference in success rate between the prostatitis group (57.1%) and non-prostatitis group (50.0%). After excluding 15 sonographically abnormal patients, the finasteride-prostatitis group showed an 80% (8/10) success rate whereas the non-prostatitis group showed a 25% (3/12) success rate. CONCLUSIONS: Finasteride treatment in hemospermia was more successful in prostatitis than non-prostatitis patients. Efficacy was more prominent after excluding sonographically abnormal cases. Finasteride could be an useful agent in the treatment of prostatitis-related hemospermia. More extensive study is needed.
Finasteride* ; Hemospermia* ; Humans ; Prostatitis ; Semen ; Semen Analysis ; Ultrasonography

Hematospermia, the presence of blood in the semen is a distressing symptom in sexually active men. However, it is usually a self-limiting condition. Although its exact incidence remains unclear, physicians should evaluate such patients closely and thoroughly because of the possibility of underlying malignancy, particularly prostate cancer. Still, confusion remains about how best to evaluate and treat men with hematospermia. The following paper reviews the literature to explain the cause, diagnostic work-up, and management strategies in patients with hematospermia.
Ejaculation ; Hemospermia ; Humans ; Incidence ; Male ; Prostatic Neoplasms ; Semen

PURPOSE: To describe MR findngs of the seminal tract using endorectal surface coil(ECMR) in patients with hemospermia and to compare them with transrectal ultrasonography(TRU TR US). MATERIALS AND METHODS: Twenty-fourpatients with hemospermia underwent MR imaging using a 1. 5T unit. T2-weighted fast spin echo axial, sagittal and coronal images, and T1-weighted spin echo axial images were obtained using on endorectal surface coil. MR finding sin 17 patients were compared with TRUS performed by urologist. RESULTS: Twenty-two patients(92%) demonstrated morphological abnormalities in the prostate and the seminal tract. On ECMR, 16 hemorrhagic foci were seen in 13patients. Prostatic cysts were seen in 14 patients(8 m llerian and 6 wolffian). These cysts showed high signal intensity on T2-weighted images. On T1-weighted images, m llerian duct cysts showed low signal intensity and wolffian duct cysts showed high signal intensity. On ECMR, calculi were seen in 18 patients. Of 17 cases who had both ECMR and TRUS, prostatic cysts were seen in 11 on ECMR and 5 cases on TRUS (p<0.05). No hemorrhage in theseminal tract was detected on TRUS. In is cases, calculi were clearly defined on ECMR, and in 11 cases on TRUS(p<0.1). CONCLUSIONS: ECMR demonstrated various lesions in patients with hemospermia and was superior to TRUS inthe localization of hemorrhage and detection of prostatic cysts and calculi.
Calculi ; Hemorrhage ; Hemospermia* ; Humans ; Magnetic Resonance Imaging* ; Prostate ; Ultrasonography*

Seventeen patients were treated for chronic bacterial prostitis by an injection of 2 gm fosfomycin sodium via perineal route directly into the prostate. Cure rate was 70% of the seven patients who allowed follow-up study at six months after Treatment with one injection. The pain, discomfortness, hematuria and hemospermia were improved except one case. Results demonstrated that direct injection into the prostate offers a new alternative method in the treatment of chronic bacterial prostatitis.
Follow-Up Studies ; Fosfomycin* ; Hematuria ; Hemospermia ; Humans ; Prostate* ; Prostatitis* ; Sodium*

Transabdominal scan of seminal vesicles with combined use of electronic linear probe and mechanical sector scanner was performed on normal adults and patients with seminal vesicular disease. The images of seminal vesicles were demonstrated easily through the multidirectional and multirotational handling of the scanners on the lower abdomen. The Ultrasonographic interpretation of the size, shape and contour of seminal vesicles together with the display of the internal structures within seminal vesicles was proved to be useful in the diagnosis of seminal vesicular diseases, particularly in the screening of underlying lesions of patients with hematospermia. The method is simple, atraumatic, and requires no special apparatus. It is concluded that the method is useful for the screening examination of seminal vesicular diseases.
Abdomen ; Adult ; Diagnosis ; Hemospermia ; Humans ; Mass Screening ; Seminal Vesicles* ; Ultrasonography*