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Abstract
Purpose
The aims of this study were to investigate the clinical significance of transrectal ultrasonography (TRUS) and the efficacy of dutasteride (5α-reductase inhibitor) in patients with hemospermia.
Materials and Methods
From January 2005 to December 2008, 60 patients with hemospermia were enrolled in the study. All patients underwent a digital rectal examination and TRUS; serum prostate specific antigen was also measured. The management of hemospermia was one of the following: watchful waiting, dutasteride treatment, or antibiotics with dutasteride.
Results
Thirty-four patients (56.7%) had positive findings on TRUS. There were 16 cases (26.7%) of prostate calcification, 13 cases (21.7%) of ejaculatory duct cyst, 3 cases (5%) of ejaculatory duct calcification, a case of seminal vesicle inflammation, and a case of ejaculatory duct dilation. Dutasteride treatment resulted in improvement of symptoms in 87.9% (29/33) of the cases, whereas treatment with antibiotics or antibiotics with dutasteride resulted in a 100% (6/6) success rate. However, among 14 watchful waiting patients, only 3 patients (21.4%) showed an improvement of symptoms.
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Fig. 1.
Transrectal ultrasonographic (TRUS) findings in patients with hemospermia. (A) Prostate multiple calcifications. (B) Ejaculatory duct cysts (＋: ejaculatory duct cyst). (C) Ejaculatory duct calcifications. (D) Seminal vesicle calcifications. (E) Ejaculatory duct dilation.
Table 1.
Patient characteristics
Table 2.
Abnormal findings in transrectal ultrasonography
Table 3.
Various methods of managing hemospermia
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