Objective. To evaluate transrectal ultrasound in the assessment of chr
onic hematospermia. Methods. Twenty-six patients aged between twenty-f
ive and seventy-seven years (mean, 55.6 years) presenting with persist
ent hematospermia of an average duration of 10.2 months (range, 3 to 2
0 months) underwent transrectal ultrasound. Twenty-five asymptomatic m
en aged thirty-nine to eighty-two years (mean, 63 years) self-referred
to our institution seeking transrectal ultrasound as a screening meth
od for prostate cancer and with no previous history of hematospermia w
ere used as controls. Results Significant sonographic findings not pre
sent in the control group were detected in 24 patients with hematosper
mia. These consisted of dilated seminal vesicles in 8, ejaculatory duc
t cysts in 4, ejaculatory or seminal vesicle calculi in 4, the presenc
e of ejaculatory duct and seminal vesicle dilatation in 4, seminal ves
icle cysts with ipsilateral renal agenesis and absence of the vas in 2
, and an intraprostatic mullerian duct remnant in 2. Of the patients h
aving biopsies, none was found to have malignancy. Conclusions. Transr
ectal ultrasound is the imaging modality of choice in the assessment o
f chronic hematospermia.