Transutricular Seminal-Vesiculoscopy in the Management of Hematospermia

Byon, Sang Kwon; Rha, Koon Ho; Yang, Seung Choul

Abstract

PURPOSE: To evaluate the etiology and treatment of options in patients with hematospermia, we performed endoscopy of the seminal vesicles in 37 patients with hematospermia.
MATERIALS AND METHODS
The patients were evaluated with either transrectal ultrasound (TRUS) or endorectal MRI. Mean age was 47.1 years (range 28-68 years) with duration of infliction being 37 months (range 3 months to 10 years). When the patients who had the definite abnormalities on the imaging studies and did not improve by medications for more than 3 months, transutricular seminal-vesiculoscopy using 6Fr or 9Fr rigid ureteroscope was performed. Patients were followed for more than 3 months after the endoscopic treatment.
RESULTS
Hemorrhage was found in the seminal vesicles and the ejaculatory ducts in 23 (62.2%) and 3 (8.1%), respectively. Calculi were present in the seminal vesicles and the ejaculatory ducts in 6 (16.2%) and 2 (5.4%), respectively. Prostatitis was present in 9 (24.3%) patients. All patients except one reported improvement of hematospermia. Postoperative complications including epididymitis or retrograde ejaculation were not observed.
CONCLUSIONS
Our series is the first large-scale experience of the seminal vesicle endoscopy in vivo. Transutricular seminal vesiculoscopy can be performed easily with conventional endoscopic equipment. The endoscopic evaluation and management of the hematospermia is a viable clinical option.