Korean J Urol.  2005 Apr;46(4):388-393.

Effectiveness of Endoscopic Management in Recurrent Hematospermia

Affiliations
  • 1Department of Urology, The Catholic University of Korea College of Medicine, Seoul, Korea. siseo@catholic.ac.kr

Abstract

PURPOSE: To evaluate the usefulness and effectiveness of endoscopic management for recurrent hematospermia, we performed transurethral endoscopy of the seminal vesicles in patients with recurrent hematospermia, despite the administration of oral medication.
MATERIALS AND METHODS
Sixteen patients were enrolled this study. Initially, all patients were treated with oral antibiotics for 6-8 weeks. Transrectal ultrasound (TRUS) and/or MRI were performed to find the anatomic abnormality and its relation with pelvic organs. The mean patient age and duration of symptoms were 43.9 years (range 24-64 years) and 21.3 months (range 1-108), respectively. We used a 6.5Fr. rigid ureteroscope and/or 14Fr. endoureterotomy instruments for the seminal vesiculoscopic examination. Patients were followed for more than 12 months after the procedures.
RESULTS
An endoscopic seminal vesicle examination was able to be successfully performed in all patients. A midline cyst was found at 10 cases, which were fulgurated. Endoscopic incisions or dilation of the ejaculatory duct were performed in all patients. An ejaculatory duct stone was found at 5 cases, and removed endoscopically. All patients reported improvement of hematospermia after the procedure, and 3 with perineal discomfort became symptom free. Postoperative complications, such as epididymitis, orchitis and ejaculatory abnormalities, were not observed in any patient.
CONCLUSIONS
Transurethral endoscopic interventions of the seminal vesicles can be performed easily with a conventional 6.5Fr. rigid ureteroscope and/or 14Fr. endoureterotomy instruments. Transurethral endoscopic managements were effective and safe treatment options in recurrent hematospermia patients.

Keyword

Hemorrhage; Semen; Endoscopy; Seminal vesicle

MeSH Terms

Anti-Bacterial Agents
Ejaculatory Ducts
Endoscopy
Epididymitis
Hemorrhage
Hemospermia*
Humans
Magnetic Resonance Imaging
Male
Orchitis
Postoperative Complications
Semen
Seminal Vesicles
Ultrasonography
Ureteroscopes
Anti-Bacterial Agents
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