AB232. The aetiology and efficacy of the treatment of persistent and recurrent hemospermia

OBJECTIVE: To describe the aetiology and efficacy of the treatment of persistent and recurrent hemospermia as a novel technique of transurethral seminal vesiculoscopy. METHODS: The clinical data of 290 patients with persistent and recurrent hemospermia (a course of hemospermia persisting more than 6 months) from multiple medical center of South China were analyzed retrospectively. The age ranged from 16 to 69 years (mean 31 years). The definite etiologies of persistent and recurrent hemospermia were confirmed by physical examination including digital rectal examination (DRE), tailored investigations such as blood PSA and clotting time, transrectal ultrasound (TRUS), CT or MRI. Of those with persistent and recurrent hemospermia, 269 patients were successfully performed by transurethral seminal vesiculoscopy since July 2008. The aetiology of the other 21 cases with persistent hemospermia were attributable to cystadenoma of the seminal vesicle [1], tuberculosis of tractus genitalis [1], bleeding risk secondary to liver cirrhosis [3], benign prostatic hyperplasia [12] and prostate cancer [4] confirmed by urogenital instrumentation or prostate biopsy. RESULTS: All the patients with persistent and recurrent hemospermia were confirmed by transurethral seminal vesiculoscopy (162 seminal vesiculitis and 108 seminal stone secondary to them, 91 ejaculatory ducts obstruction incompletely, 42 Mullerian cyst, 16 cysts of seminal vesicle, 3 cysts of ejaculatory duct and 12 benign prostatic hyperplasia). The mean operative time was 21 min (range, 5–90 min). There were no complications including injury of urethra and seminal vesicle and postoperative discomforts in the perineal region. The mean follow-up period was 24 months (range, 3–72 months). In those 269 cases, 11 patients were out of follow-up. Hematospermia in 235 cases disappeared and 23 patients respectively recurred in 5 to 60 months after receiving transurethral seminal vesiculoscopy. Of those 23 cases with postoperatively recurrent hemospermia, 12 patients were cured by re-transurethral seminal vesiculoscopy. CONCLUSIONS: The aetiologies of persistent and recurrent hemospermia are mostly associated with seminal vesiculitis and seminal stone secondary to vesiculitis or ejaculatory ducts obstruction incompletely. Transurethral seminal vesiculoscopy could be an effective diagnostic and therapeutic procedure for it.