What are the diagnostic possibilities for a patient with hematospermia of several months’ duration whose physical examination and lab studies are normal?
—Mario E. Palacious, MD, Egg Harbor Twp, N.J.
Hematospermia almost always results from the nonspecific inflammation of the prostate and/or seminal vesicles. The condition generally resolves spontaneously, usually within several weeks. If it persists, a rectal exam, prostate-specific antigen determination, and urine cytology should be done (Walsh PC, Retik AB, Vaughan ED Jr, et al, eds. Campbell’s Urology. 8th ed. Philadelphia, Pa.: WB Saunders; 2002:90). I have seen some patients whose hematospermia persisted for many months, and I have occasionally resorted to empiric antibiotic therapy (although I’m not sure that approach had much value).
—David T. Noyes, MD (105-18)