Hemospermia: What’s the Outcome?
August 1, 2014 less than 1 minute read
The presence of blood in the semen is an unsettling experience for men and usually stimulates prompt consultation. Fortunately, this research article by Zargooshi et al provides very reassuring outcomes data.
From a general urology clinic in Iran, the investigators included all patients with hemospermia seen in their outpatient clinic over a 16-year span (n = 165). Mean age of the subjects was 38 years, but almost 20% of subjects were over age 50. Mean follow-up was 7 years. Study subjects underwent ultrasound of the testes and abdomen, and laboratory evaluation. In the absence of positive findings, subjects were empirically treated with a course of a fluoroquinolone plus a nonsteroidal anti-inflammatory drug (NSAID).
Pathology was discerned in only 3 of 165 patients: one case of tuberculosis, one case of bladder cancer, and one case of ejaculatory duct stones. The authors point out that during the 15-year span of the study, no patient developed life-threatening disease, and post-treatment recurrences were rare.
According to this trial, if hemospermia resolves after a course of antibiotics and NSAIDs, further investigation is unlikely to disclose meaningful pathology. Full evaluation should be reserved for recurrences or other high-risk indicators.
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