title: A clinical entity of cystic dilatation of the utricle associated with hemospermia.
abstract: OBJECTIVE
  We investigated the mechanism of hemospermia in patients with a midline cyst (MLC) of the prostate, focusing on cystic dilatation of the utricle (CDU) as a possible causative lesion.
  
  
  METHODS
  Of 138 patients with hemospermia 30 (22%) had an MLC, of whom 19 underwent transperineal needle aspiration of the MLC and bilateral seminal vesicles to determine the site of bleeding. Following MLC aspiration a mixture of dye and contrast medium was injected. The verumontanum was observed endoscopically and pelvic x-ray was done.
  
  
  RESULTS
  Seminal vesicle fluid on 1 or 2 sides was hemorrhagic in 13 of the 19 patients (aspiration failed in 6) and fluid from the MLC was nonhemorrhagic in 5 of the 19 (aspiration failed in 7). The MLC communicated with the urethra (CDU) in 15 patients (79%) and with 1 or 2 ejaculatory ducts in 11 (58%). In 5 of 11 patients with communication with the ejaculatory duct hemospermia persisted for more than 1 year. Four of these patients were cured by transurethral unroofing of the CDU.
  
  
  CONCLUSIONS
  CDU is a significant underlying lesion for hemospermia. Communication with the ejaculatory ducts was frequent in patients with chronic hemospermia and transurethral unroofing was effective for eliminating hemospermia.
authors.affiliation: Department of Urology, Furuya Hospital, Kitami, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Furuya
authors.forename: Haruaki
authors.initials: H
authors.lastname: Kato
mesh_terms: D000328:Adult; D000368:Aged; D001769:Blood; D003560:Cysts / Q000175:diagnosis* / Q000601:surgery; D003937:Diagnosis, Differential; D004108:Dilatation, Pathologic; D004543:Ejaculatory Ducts / Q000473:pathology / Q000601:surgery; D019160:Endosonography; D006801:Humans; D008297:Male; D008875:Middle Aged; D011469:Prostatic Diseases / Q000150:complications* / Q000175:diagnosis; D012661:Semen; D012669:Seminal Vesicles / Q000473:pathology / Q000601:surgery; D013396:Suction; D014521:Urethra / Q000002:abnormalities / Q000473:pathology / Q000601:surgery