Skip to main content

Finasteride for treatment of refractory hemospermia: prospective placebo-controlled study


Finasteride had been used to control frequent hematuria due to BPH. In this study, we tried to test the efficacy of finasteride to control refractory idiopathic hemospermia lasting for more than 3 months for which conservative treatment has failed.

Patients and methods

In a period from 1998 to 2008, 70 patients with hemospermia presented to urology department, Sohag university hospital. Only 24 patients were diagnosed as having refractory hemospermia of idiopathic nature. They were divided and randomized into two equal groups, 12 patients each. One group received finasteride 5 mg daily for 3 months, and the second group received placebo. Patients were followed at monthly intervals both subjectively and objectively by semen analysis and TRUS for three successive months and after 1 year.


In the finasteride-treated group, 8 patients (66.7%) have demonstrated a remission of the episodes of their hemospermia symptom within 2–5 weeks after the start of treatment. We confirmed this subjective improvement by repeated semen analysis. Patients continued treatment for 3 months without recurrence of bleeding. On the other hand, only three patients (25%) in placebo group mentioned the disappearance of their symptom after a period of 1–2 months on treatment. On semen analysis, those three patients showed considerable number of RBCs (>50/HPF).


Finasteride could be safely used as a treatment for patients with idiopathic refractory hemospermia after exclusion of the other organic causes. However, our results are preliminary, and larger series with longer follow-up are required to confirm the results.

This is a preview of subscription content, access via your institution.


  1. Han M, Brannigan RE, Antenor JA, Roehl KA, Catalona WJ (2004) Association of hemospermia with prostate cancer. J Urol 172(6 Pt 1):2189–2192

    Google Scholar 

  2. Sieber PR, Rommel FM, Huffnagle HW, Breslin JA, Agusta VE, Harpster LE (1998) The treatment of gross hematuria secondary to prostatic bleeding with finasteride. J Urol 159:1232–1233

    Article  PubMed  CAS  Google Scholar 

  3. Deering RE, Bigler SA, Brown M et al (1995) Microvascularity in benign prostatic hyperplasia. Prostate 26(3):111–115

    Article  PubMed  CAS  Google Scholar 

  4. Mulhall JP, Albertsen PC (1995) Hemospermia: diagnosis and management. Urology 46:463–467

    Article  PubMed  CAS  Google Scholar 

  5. Stefanovic KB, Gregg PC, Soung M (2009) Evaluation and treatment of hematospermia. Am Fam Physician 80(12):1421–1427

    PubMed  Google Scholar 

  6. Ahmad I, Krishma NS (2007) Hemospermia. J Urol 177(5):1613–1618

    Article  PubMed  Google Scholar 

  7. Yagci C, Kupeli S, Tok C, Fitoz S, Baltaci S, Gogus O (2004) Efficacy of transrectal ultrasonography in the evaluation of hematospermia. Clin Imag 28:286

    Article  Google Scholar 

  8. Worischeck JH, Parra RO (1994) Chronic hematospermia: assessment by transrectal ultrasound. Urology 43:515

    Article  PubMed  CAS  Google Scholar 

  9. Sauvaina JL, Palascakb P, Bourscheidc D, Chabib C, Atassib A, Bremona JM, Palascakb R (2003) Value of power doppler and 3DVascular sonography as a method for diagnosis and staging of prostate cancer. Eur Urol 44:21–31

    Article  Google Scholar 

  10. Kaplan SA (2001) 5 alpha-reductase inhibitors: what role should they play? Urology 58 (6 suppl 1):65–70 (discussion 70)

  11. Memis A, Ozden C, Ozdal OL, Guzel O, Han O, Seckin S (2008) Effect of finasteride treatment on suburethral prostatic microvessel density in patients with hematuria related to benign prostate hyperplasia. Urol Int 80(2):177–180

    Article  PubMed  CAS  Google Scholar 

  12. Donohue JF, Hayne D, Karnik U, Thomas DR, Foster MC (2005) Randomized, placebo-controlled trial showing that finasteride reduces prostatic vascularity rapidly within 2 weeks. BJU Int 96(9):1319–1922

    Article  PubMed  CAS  Google Scholar 

  13. Miller MI, Puchner PJ (1998) Effects of finasteride on hematuria associated with benign prostatic hyperplasia: long-term follow-up. Urology 51:237–240

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Abdelbasset A. Badawy.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Badawy, A.A., Abdelhafez, A.A. & Abuzeid, A.M. Finasteride for treatment of refractory hemospermia: prospective placebo-controlled study. Int Urol Nephrol 44, 371–375 (2012).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:


  • Hemospermia
  • Finastride
  • Idiopathic
  • Semen
  • Prostate