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Australian Family Physician Dec 2015Haematospermia is an alarming symptom for patients. Reassuringly, most cases are benign in origin and self-limiting. Occasionally, however, an underlying malignancy is... (Review)
Review
BACKGROUND
Haematospermia is an alarming symptom for patients. Reassuringly, most cases are benign in origin and self-limiting. Occasionally, however, an underlying malignancy is responsible and must not be missed by the treating doctor.
OBJECTIVE
The aim of this article is to review the causes, diagnosis and management of haematospermia in the primary care setting. This review will describe an approach to haematospermia that general practitioners (GPs) can apply to daily practice.
DISCUSSION
There are numerous potential causes of haematospermia, the most common of which are infection and iatrogenic. Specific red flags of haematospermia identified on clinical assessment and basic investigations help to distinguish between harmless haematospermia and one that will need specialist referral. The management of haematospermia will depend on the underlying cause.
Topics: General Practice; Hemospermia; Humans; Male; Referral and Consultation
PubMed: 27054210
DOI: No ID Found -
Medicina (Kaunas, Lithuania) 2005Hemospermia refers to the presence of blood in the seminal fluid and is not very common urologic symptom. Its prevalence remains unknown. Historically, hemospermia was... (Comparative Study)
Comparative Study Review
Hemospermia refers to the presence of blood in the seminal fluid and is not very common urologic symptom. Its prevalence remains unknown. Historically, hemospermia was linked to excessive sexual overindulgence, prolonged sexual abstinence, interrupted coitus. Newer imaging modalities have altered the diagnosis and etiological factors of hemospermia are now more frequently identified. Hemospermia can result from many causes. Infections or inflammatory disorders account from 39% to 55% of cases, malignancies and trauma account just 4-13%. The remaining 11% of cases were caused by a variety of other pathologic conditions. Predisposing diseases are prostatitis, epididymitis, urinary stones, tuberculosis, cirrhosis of the liver, arterial hypertension, hematologic diseases. In 30-70% of the cases there is no association with any significant pathology. Cases of primary and solitary hemospermia can be adequately assessed by urinanalysis, blood pressure measurement, genital and rectal examination, PSA-test, and reassurance of the patient. Persistent and recurrent cases of hemospermia are best clarified by transrectal ultrasound examination, cystoscopy, computer tomography and magnetic resonance imaging. Treatment depends on the diagnostic findings but often simply involves reassurance.
Topics: Adult; Algorithms; Cystoscopy; Diagnosis, Differential; Ejaculation; Epididymitis; Hemospermia; Humans; Hypertension; Liver Cirrhosis; Magnetic Resonance Imaging; Male; Middle Aged; Prostate-Specific Antigen; Prostatitis; Recurrence; Tomography, X-Ray Computed; Ultrasonography; Urinary Calculi
PubMed: 15864011
DOI: No ID Found -
International Braz J Urol : Official... 2017In this video Mello et al. (1), the authors highlight the clinical merit of step-step laproscopic vesiculectomy for hemospermia. The authors adopt a robotic minimally...
In this video Mello et al. (1), the authors highlight the clinical merit of step-step laproscopic vesiculectomy for hemospermia. The authors adopt a robotic minimally invasive surgery to the realm of seminal vesiculectomy, which was first highlighted by Kavoussi et al. in 1993 (2). It depicts an easy step-by step approach and nicely demonstrates how to mange the vascular pedicle. The present video highlights that that this be accomplished to address an underlying clinical manifestation requiring surgical resection. In their series Mello et al. (1) pathological analysis showed amyloidosis, and transitional epithelium without atypia. With the advantage of combined 3D vision and wristed instrumentation, robotic excision of the seminal vesicles is feasible, safe and regarded as a natural continuity of conventional laparoscopy.
Topics: Hemospermia; Humans; Laparoscopy; Seminal Vesicles
PubMed: 28783268
DOI: 10.1590/S1677-5538.IBJU.2016.0127.1 -
Translational Andrology and Urology Oct 2017Hematospermia is defined by the presence of blood in the semen typically occurring in men younger than 40 years of age. Symptoms can occur due to a multitude of reasons,... (Review)
Review
Hematospermia is defined by the presence of blood in the semen typically occurring in men younger than 40 years of age. Symptoms can occur due to a multitude of reasons, but are usually benign and self-limiting, requiring no additional treatment or evaluation. Despite this, the condition often impairs quality of life due to associated anxiety and must be taken seriously by the patient and the physician, particularly if recurrent, refractory, and painful. The etiology of hematospermia can be classified into inflammatory, infectious, lithiasis, cystic, obstructive, tumoral, vascular, traumatic, iatrogenic, and systemic origin. Alternatively, it can also be divided into subcategories based on anatomical origins such as prostate, bladder, spermatic cord, seminal vesicles, or epididymis. A complete history and physician examination, laboratory testing, and a variety of invasive and non-invasive imaging and instrumentation modalities can help to identify and treat the underlying pathology promptly.
PubMed: 29184797
DOI: 10.21037/tau.2017.06.01 -
Clinical Microbiology and Infection :... May 2017Zika virus (ZIKV) is transmitted to humans primarily by Aedes mosquito bites. However, circumstantial evidence points to a sexual transmission route. (Review)
Review
BACKGROUND
Zika virus (ZIKV) is transmitted to humans primarily by Aedes mosquito bites. However, circumstantial evidence points to a sexual transmission route.
OBJECTIVES
To assess the sexually acquired ZIKV cases and to investigate the shedding of ZIKV in genital fluids.
DATA SOURCES
PubMed, Scopus, Pro-MED-mail and WHO ZIKV notification databases from inception to December 2016.
SELECTION CRITERIA
Reports describing ZIKV acquisition through sex and studies reporting the detection or isolation of ZIKV in the genital fluids were included.
RISK-OF-BIAS ASSESSMENT
The risk of bias was assessed using the National Institute of Health Tool.
RESULTS
Eighteen studies reporting on sex-acquired ZIKV and 21 describing the presence of ZIKV in genital fluids were included. The overall risk of bias was moderate. Sexual transmission was male-female (92.5%), female-male (3.7%) and male-male (3.7%). Modes of sexual transmission were unprotected vaginal (96.2%), oral (18.5%) and anal (7.4%) intercourse. The median time between onset of symptoms in the index partner and presumed sexual transmission was 13 days (range 4-44 days). ZIKV RNA was detected in semen as late as 188 days (range 3-188 days) following symptom onset, and infectious virus was isolated in semen up to 69 days after symptom onset. No study reported ZIKV isolation from female genital samples, but detection did occur up to 13 days after symptom onset.
CONCLUSIONS
ZIKV is potentially sexually transmitted and persists in male genital secretions for a prolonged period after symptom onset. PROSPERO systematic review registration number CRD42016041475.
Topics: Aedes; Animals; Databases, Factual; Female; Hemospermia; Humans; Male; Observational Studies as Topic; Saliva; Sexually Transmitted Diseases; Vagina; Zika Virus; Zika Virus Infection
PubMed: 28062314
DOI: 10.1016/j.cmi.2016.12.027 -
Deutsches Arzteblatt International Mar 2017Hematospermia, or blood in the ejaculate, is a symptom with many possible causes that often gives rise to worry. Precise figures on its prevalence are unavailable. It is... (Review)
Review
BACKGROUND
Hematospermia, or blood in the ejaculate, is a symptom with many possible causes that often gives rise to worry. Precise figures on its prevalence are unavailable. It is most common in men under 40, and its cause is usually benign; nonetheless, even a single episode of hematospermia calls for a basic diagnostic evaluation.
METHODS
This review is based on pertinent articles re trieved by a search in PubMed with the key words "hemato spermia," "hemospermia," "ejaculation," "male semen," and "transrectal ultrasound."
RESULTS
A diagnostic algorithm for hematospermia is described. The most common cause is iatrogenic trauma, in particular transrectal ultrasound-guided prostate biopsy to rule out prostate cancer. Urogenital infections are the second most common cause. Pathological changes of the prostate should be considered along with systemic causes, e.g., arterial hypertension or various hematologic disorders. A single event in men under 40 should be evaluated by precise history-taking, a meticulous physical examination including blood-pressure measurement, and urinalysis. Repeated episodes, or hematospermia in men over 40, calls for additional evaluation with further laboratory tests, imaging studies, and, in some cases, interventional diagnostic procedures.
CONCLUSION
Further tests, preferably imaging studies, seem a reasonable way to detect or exclude potential causes of hematospermia, especially malignant ones. The treatment is directed at the underlying cause.
Topics: Hemospermia; Humans; Male; Prospective Studies; Prostatic Neoplasms; Retrospective Studies; Ultrasonography
PubMed: 28382905
DOI: 10.3238/arztebl.2017.0186 -
European Urology Mar 2017Prostate biopsy (PB) represents the gold standard method to confirm the presence of cancer. In addition to traditional random or systematic approaches, a magnetic... (Review)
Review
CONTEXT
Prostate biopsy (PB) represents the gold standard method to confirm the presence of cancer. In addition to traditional random or systematic approaches, a magnetic resonance imaging (MRI)-guided technique has been introduced recently.
OBJECTIVE
To perform a systematic review of complications after transrectal ultrasound (TRUS)-guided, transperineal, and MRI-guided PB.
EVIDENCE ACQUISITION
We performed a systematic literature search of Web of Science, Embase, and Scopus databases up to October 2015, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Complications and mortality following random, systematic, and image-guided PBs were reviewed. Eighty-five references were included.
EVIDENCE SYNTHESIS
The most frequent complication after PB was minor and self-limiting bleeding (hematuria and hematospermia), regardless of the biopsy approach. Occurrence of rectal bleeding was comparable for traditional TRUS-guided and image-guided PBs. Almost 25% of patients experienced lower urinary tract symptoms, but only a few had urinary retention, with higher rates after a transperineal approach. Temporary erectile dysfunction was not negligible, with a return to baseline after 1-6 mo. The incidence of infective complications is increasing, with higher rates among men with medical comorbidities and older age. Transperineal and in-bore MRI-targeted biopsy may reduce the risk of severe infectious complications. Mortality after PB is uncommon, regardless of biopsy technique.
CONCLUSIONS
Complications after PB are frequent but often self-limiting. The incidence of hospitalization due to severe infections is continuously increasing. The patient's general health status, risk factors, and likelihood of antimicrobial resistance should be carefully appraised before scheduling a PB.
PATIENT SUMMARY
We reviewed the variety and incidence of complications after prostate biopsy. Even if frequent, complications seldom represent a problem for the patient. The most troublesome complications are infections. To minimize this risk, the patient's medical condition should be carefully evaluated before biopsy.
Topics: Biopsy; Endosonography; Erectile Dysfunction; Hematuria; Hemospermia; Humans; Image-Guided Biopsy; Lower Urinary Tract Symptoms; Magnetic Resonance Imaging; Male; Postoperative Complications; Postoperative Hemorrhage; Prostate; Prostatic Neoplasms; Recovery of Function; Rectal Diseases; Surgical Wound Infection; Urinary Retention
PubMed: 27543165
DOI: 10.1016/j.eururo.2016.08.004 -
BMC Urology Nov 2022Most patients with splenosis have no clinical symptoms and do not need intervention. Hematospermia and testicular pain occurred in this patient, which was considered to...
BACKGROUND
Most patients with splenosis have no clinical symptoms and do not need intervention. Hematospermia and testicular pain occurred in this patient, which was considered to be related to the huge pelvic implantation of the spleen, which was relatively rare in clinical practice, so we hereby report this case.
CASE PRESENTATION
A 28-year-old male patient with a history of splenectomy was admitted to the Urology Department of the Second Affiliated Hospital of Anhui Medical University with the chief complaint of "Hematospermia for 1 month and testicular pain for 2 days". Preoperative imaging examination indicated pelvic mass. Combined with the patient's history of splenectomy for splenic rupture in childhood, the possibility of pelvic spleen implantation was considered. Laparoscopic pelvic exploration was performed. During the operation, multiple grayish-brown nodular tissues were observed in the space between the posterior bladder and rectum, and a lobulated grayish-brown mass with a diameter of about 9 cm was observed in the posterior upper part of the prostate gland and seminal vesicle at the pelvic floor. Two nodular tissues were removed intraoperatively and sent for quick frozen pathology, which was reported as spleen tissue. Further resection of the huge mass was performed, and the postoperative pathological results were consistent with the diagnosis of splenosis.
CONCLUSION
We report a rare case of splenosis presenting with hemospermia and testicular pain.
Topics: Male; Humans; Adult; Splenosis; Hemospermia; Splenectomy; Pain
PubMed: 36384575
DOI: 10.1186/s12894-022-01138-w -
Proceedings of the Royal Society of... Aug 1942
PubMed: 19992551
DOI: No ID Found -
Canadian Family Physician Medecin de... Apr 1991Most patients are very anxious when they consult their physician for hemospermia. The most frequent cause is an inflammation of the prostrate, the posterior urethra or...
Most patients are very anxious when they consult their physician for hemospermia. The most frequent cause is an inflammation of the prostrate, the posterior urethra or the seminal vesides, such as chronic prostatitis or posterior urethritis. Neoplasia, tuberculosis and schistosomiasis are very rare. In approximately 40% of all cases, no obvious cause is found. With the information that follows, you will be able to reassure the patient in most cases.
PubMed: 21229072
DOI: No ID Found