CURRENT PERSPECTIVES ON HEMATOSPERMIA - A REVIEW

Hematospermia is a disconcerting symptom that produces extreme anxiety in sexually active male patients. To understand the pathophysiology o f hematospermia, the anatomy of the ejaculatory system and neurophysio logy of emission and ejaculation is essential. Emission and ejaculatio n must be present for hematospermia to occur. Hematospermia may be the result of inflammation, infection, ductal obstruction or cysts, neopl asms, vascular abnormalities, and systemic or iatrogenic factors. Most patients promptly consult a urologist after an episode of hematosperm ia. History and physical examination are often unrevealing and the jud icious use of imaging modalities, such as transrectal ultrasound, MRI, and rigid or flexible endoscopy, may be diagnostic. Unless the specif ic etiology is defined, most cases are managed expectantly. We review the etiology of hematospermia and an algorithm is provided for the dia gnosis and management.