Haematospermia as a presenting symptom: Outcomes of investigation in 300 men

Ng, Yeung H.; Seeley, Jonathan P.; Smith, Gordon

doi:10.1016/j.surge.2012.04.004

Cited by 34 publications

(46 citation statements)

References 10 publications

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“…When the patients were divided into those under and over 40 years of age, urinary tract infections were more common among younger patients vs. older patients (15% vs. 10.3%). In the older group (>40 years old), stones (2.2% vs. 1.4%) and malignancy (6.2% vs. 1.4%) were more common when compared with the younger cohort (71). In the over 40 group, 13 patients had prostate cancer and 1 had a low-grade urethral carcinoma.…”

Section: Hemospermiamentioning

confidence: 92%

“…The symptom represents approximately 1–1.5% of all urological referrals and occurs in all age groups with a mean age of 37 (69,71). It is usually a self-limiting condition with an average duration of 1–24 months (69,70).…”

Section: Hemospermiamentioning

confidence: 99%

“…In the over 40 group, 13 patients had prostate cancer and 1 had a low-grade urethral carcinoma. In the under 40 group, 1 patient had testicular cancer (71). …”

Section: Hemospermiamentioning

confidence: 99%

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Retrograde ejaculation, painful ejaculation and hematospermia

Parnham

Şerefoğlu

2016

Transl. Androl. Urol.

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Although there has been an increased interest on premature ejaculation in the recent years, our understanding regarding the disorders of retrograde ejaculation, painful ejaculation and hematospermia remain limited. All three of these conditions require a keen clinical acumen and willingness to engage in thinking outside of the standard established treatment paradigm. The development of novel investigational techniques and treatments has led to progress in the management of these conditions symptoms; however, the literature almost uniformly is limited to small series and rare randomised trials. Further investigation and randomised controlled trials are needed for progress in these often challenging cases.

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Section: Hemospermiamentioning

confidence: 92%

Section: Hemospermiamentioning

confidence: 99%

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Retrograde ejaculation, painful ejaculation and hematospermia

Parnham

Şerefoğlu

2016

Transl. Androl. Urol.

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“…4 Since then there have been a number of significant papers published regarding the diagnosis and management of haematospermia. [5][6][7][8][9] In 2016, NICE also published guidelines on management of haematospermia. 10…”

Section: New Researchmentioning

confidence: 99%

The diagnosis and management of haematospermia

Gallagher

Ramsden

2019

Trends Urol & Men's Health

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“…3 8 Prostate cancer presents with isolated haematospermia between 3.7% and 13.7% of the time. [4][5][6][7][8][9][10] Raised concentrations of prostate specific antigen and an abnormal digital rectal examination with haematospermia increase these chances. 4 Provenance and peer review: Commissioned and externally peer reviewed.…”

Section: Box 2: Advice For Men Experiencing Haematospermiamentioning

confidence: 99%

Haematospermia

Drake

Hanna

Davies

2016

BMJ

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A 40 year old man complains of two episodes when he noticed blood in his ejaculate. He is otherwise well and has no comorbidities.Visible blood in ejaculate-haematospermia or haemospermia-is usually an isolated symptom, and its incidence is unknown. In most cases, it is benign and self limiting, often caused by inflammation or infection of the prostate, urethra, or seminal tract. 1 Possible causes are outlined in Box 1. Patients may describe haematuria, urinary frequency, dysuria, and scrotal, pelvic, or perineal pain, particularly at the time of orgasm. 2 What you should cover HistoryAsk about:• Timing, frequency, and duration of haematospermia, and colour of the semen: bright red with or without clots (that is, fresh bleeding), or brown (old blood).• Associated urinary symptoms suggestive of infection-for example, dysuria, frequency, or urgency of urination, visible haematuria, pain in the abdomen, scrotum, pelvis, or perineum.• Sexual history, including presence of urethral discharge, which could point to a sexually transmitted infection. • Recent urological investigation or intervention.• History of prolonged or excessive bleeding or easy bruising from minor injuries or surgical procedures suggestive of bleeding disorders or a history of coagulopathy.• Travel history, particularly to areas where tuberculosis and schistosomiasis are endemic, as these can cause genitourinary tract infections.• Family history of prostate cancer, particularly in first degree relatives and relatives diagnosed under the age of 60, and coagulopathies. Examination• Ask the patient to expose the external genitalia. Palpate for any lumps, scrotal tenderness, or swelling, which could indicate underlying testicular or epididymal pathology• Perform a digital rectal examination to detect prostatic enlargement, tenderness, fluctuance, firmness, or nodules• Look for signs of easy bruising or bleeding tendencies, such as large bruises (>5 cm in diameter) in the absence of trauma, and petechiae• Examine the abdomen for hepatosplenomegaly, which could indicate an underlying haematological, liver, or infectious disease• Measure blood pressure to identify uncontrolled hypertension What you should doHaematospermia can cause alarm. Reassure patients that a single episode is likely to be benign and self limiting, and ask them to return if the problem continues (Box 2).The initial approach is to rule out infectious causes (Box 1). We suggest that these results are interpreted based on the age of the patient. However, onward referral criteria are based on expert opinion, supported by limited evidence. 3-6 The algorithm ( fig 1⇓) showing the initial assessment and management of haematospermia is based on authors' clinical experience and practice.In patients aged under 40, the most common cause is infection, and management can be guided by non-specialists. Urologists tend to recommend a prolonged course of antibiotics, usually six weeks in duration. Consider referral to a genitourinary medicine clinic if you suspect a sexually transmitted infection to ...

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Haematospermia as a presenting symptom: Outcomes of investigation in 300 men

Cited by 34 publications

References 10 publications

Retrograde ejaculation, painful ejaculation and hematospermia

Retrograde ejaculation, painful ejaculation and hematospermia

The diagnosis and management of haematospermia

Haematospermia

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