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International Urology and Nephrology

, Volume 41, Issue 1, pp 77–83 | Cite as

Hematospermia: etiological and management considerations

  • Dean E. LeocádioEmail author
  • Barry S. Stein
Urology - Original Paper

Abstract

Background

Hematospermia, or blood in the ejaculate, usually follows a benign self-limiting course. However, it can be a source of considerable anxiety in patients. The purpose of this article is to provide the primary care physician an algorithm for the evaluation and management of hematospermia based on frequency of occurrence and patient age.

Methods

We performed an English language MEDLINE (1966 to present) search for the terms hematospermia, hemospermia, management, prostate biopsy and combinations thereof. We then constructed a management algorithm based on available evidence.

Results

Typically, patients present to their primary care physician after a single episode of hematospermia out of concern for malignancy or venereal disease. In men 40 years old or younger, it is most often due to inflammatory or infectious processes. In men over 40 years of age, however, an association exists between hematospermia and more serious underlying pathology. A significant number of cases remain idiopathic even after extensive investigation.

Conclusions

Hematospermia is an anxiety-provoking sign that is usually due to inflammatory or infectious causes. Recurrent or symptomatic hematospermia may herald more serious underlying pathology, especially in those patients over 40 years old. A thorough evaluation is warranted to both rule out more serious pathology and to adequately address patient anxiety. With modern imaging techniques, the number of “idiopathic” cases should be much lower than historically reported.

Keywords

Benign prostatic hyperplasia Ejaculation Hematospermia Hemospermia Prostate biopsy 

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Copyright information

© Springer Science+Business Media, B.V. 2008

Authors and Affiliations

  1. 1.Department of UrologyTexas Tech University Health Sciences CenterLubbockUSA
  2. 2.Department of UrologyRhode Island Hospital/The Warren Alpert Medical School of Brown UniversityProvidenceUSA

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