Department of Urology, the Third Affiliated Hospital of Sun Yat-sen
University, Guangzhou 510630, Guangdong Province, China
Objective: To investigate a novel technique of transurethral
seminal vesiculoscopy with a ureteroscope for evaluation and
management of persistent and recurrent hematospermia.
Methods: The clinical data of 12 patients with persistent and
recurrent hematospermia who had undergone transurethral
seminal vesiculoscopy since September 2008 in our center were
analyzed retrospectively, and relevant literature was reviewed. Their age ranged from 26 to 67 years (mean 38 years). Twelve
patients with a course of hematospermia for 6 months to
12 years (mean: 15 months) were not cured by other treatment.
The definite etiologies of persistent and recurrent haemospermia
were excluded by physical examination including blood pressure
measurement and digital rectal examination, blood PSA and
clotting time, and further imaging investigation such as TRUS,
CT or MRI. The ejaculatory duct and seminal vesicle were
observed under direct vision through the distal seminal tracts
using a 7F rigid ureteroscope.
Results: Transurethral seminal vesiculoscopy was successfully
performed in all the 12 cases and the mean operative time was
30 min (range 15-90 min). Twelve patients were confirmed by
transurethral seminal vesiculoscopy (five seminal vesiculitis, five
seminal stone, one vas deferens obstruction, and one seminal
cyst). There were no complications including injury of urethra
and seminal vesicle and postoperative discomforts in the perineal
region. The mean follow-up period was 12 months (range 3-
36 months). Hematospermia disappeared in 10 cases and was
alleviated in one case. One patient experienced recurrence
9 months after receiving transurethral seminal vesiculoscopy.
Conclusions: Transurethral seminal vesiculoscopy can be
performed easily using slender rigid ureteroscopy with minimal
complications. It can be an effective therapeutic approach for
treating persistent and recurrent hematospermia.