Prospective trial comparing transrectal ultrasonography and transurethral seminal vesiculoscopy for persistent hematospermia.
OBJECTIVE
To compare the diagnostic yield of transrectal ultrasonography and transurethral seminal vesiculoscopy in patients with persistent hematospermia, and to determine the advantages and disadvantages of both modalities.


METHODS
We prospectively enrolled 106 patients with persistent hematospermia of mean duration 20.5 months. All patients were evaluated by both transrectal ultrasonography and transurethral seminal vesiculoscopy after excluding definite etiological lesions beyond the reproductive duct system. The diagnostic yield and other technical parameters of both modalities were compared.


RESULTS
Final diagnoses were made in 93 patients (87.7%), with transrectal ultrasonography and transurethral seminal vesiculoscopy showing overall diagnostic yields of 45.3% and 74.5%, respectively (P < 0.001). The diagnostic yield of combining transrectal ultrasonography and transurethral seminal vesiculoscopy was significantly higher than that of each modality alone (both P < 0.001). Of the 114 findings of diagnostic value, the most frequent was calculus (47.4%, n = 54), followed by obstruction/stricture (37.7%, n = 43), cyst (8.8%, n = 10), dysplasia (3.5%, n = 4), polyp (1.8%, n = 2) and benign mass (0.9%, n = 1). Transurethral seminal vesiculoscopy showed significant superiority in detecting calculi and obstruction/stricture. Hematospermia disappeared in 95.3% (101/106) of all patients and in 97.6% (83/85) of patients receiving transurethral seminal vesiculoscopy therapy during follow up. No major adverse effects occurred during and after examination.


CONCLUSIONS
The diagnostic yield of transurethral seminal vesiculoscopy for persistent hematospermia was significantly superior to that of transrectal ultrasonography, especially in lesions diagnosed with calculi and obstruction/stricture. Combining both modalities might provide extra benefits for patients with persistent hematospermia.
Shenzhen Futian Maternity and Infant Health Hospital, Shenzhen, China.
Changyong
C
Xing
Xiaomei
X
Zhou
Lei
L
Xin
Hongzhen
H
Hu
Liping
L
Li
Jingchuan
J
Fang
Zhiyong
Z
Liu
D000328:Adult; D000368:Aged; D004543:Ejaculatory Ducts / Q000000981:diagnostic imaging / Q000473:pathology*; D051516:Hemospermia / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012669:Seminal Vesicles / Q000473:pathology*; D014463:Ultrasonography / Q000379:methods; D020709:Ureteroscopes; D055815:Young Adult