title: Hyperuricemia: a possible cause of hemospermia.
abstract: OBJECTIVE
  To report our experience with hemospermia and its relation to hyperuricemia.
  
  
  METHODS
  Between July 2005 and July 2012, 143 patients with hemospermia presented to the outpatient clinic in our hospital. History, examination, workup, treatment outcomes, and long-term follow-up were reported in a prospective database. Patients were followed up monthly by semen examination till disappearance of hemospermia, then every 3 months for 1 year. We identified 43 patients, who had 4-12 hemospermia attacks for 2-10 months before presentation with no identifiable cause for hemospermia. Of them, 22 had hyperuricemia. The association between hemospermia and hyperuricemia was examined by comparing such 22 hyperuricemic hemospermic patients with the other 21 idiopathic hemospermic patients.
  
  
  RESULTS
  The commonest 5 findings identified as possible causes of hemospermia were bilharziasis (21.6%), hyperuricemia (15.4%), idiopathic (14.7%), tuberculosis (8.4%), and chronic prostatitis (8.4%). Hyperuricemic hemospermic patients were significantly of younger age (median of 31.5 vs 45 years), complaining of more painful ejaculation (68.2% vs 9.5%), and had higher serum uric acid (median, 9.3 vs 4.5 mg/dL) compared with those of idiopathic hemospermia. Hemospermia disappeared completely in all patients of the hyperuricemia group vs only 25% of the idiopathic group (P <.001) within a mean of 2 months (range, 1-4 months).
  
  
  CONCLUSIONS
  Hyperuricemia is a new probable cause of hemospermia. Further randomized studies are mandatory for establishment of our postulation.
authors.affiliation: Department of Urology, Assiut University Hospitals, Assiut University, Asyut, Egypt.
authors.forename: Adel
authors.initials: A
authors.lastname: Kurkar
authors.affiliation: Department of Urology, Assiut University Hospitals, Assiut University, Asyut, Egypt. Electronic address: ahmad.elderwy@gmail.com.
authors.forename: Ahmad A
authors.initials: AA
authors.lastname: Elderwy
authors.affiliation: Department of Dermatology and Venereology, Assiut University Hospitals, Assiut University, Asyut, Egypt.
authors.forename: Sara M
authors.initials: SM
authors.lastname: Awad
authors.affiliation: Department of Urology, Assiut University Hospitals, Assiut University, Asyut, Egypt.
authors.forename: Sherief
authors.initials: S
authors.lastname: Abulsorour
authors.affiliation: Department of Urology, Assiut University Hospitals, Assiut University, Asyut, Egypt.
authors.forename: Hassan A
authors.initials: HA
authors.lastname: Aboul-Ella
authors.affiliation: Department of Urology, Assiut University Hospitals, Assiut University, Asyut, Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Altaher
mesh_terms: D000328:Adult; D000493:Allopurinol / Q000737:chemistry; D051516:Hemospermia / Q000209:etiology*; D006801:Humans; D033461:Hyperuricemia / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011472:Prostatitis / Q000150:complications; D055101:Semen Analysis; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000493:Allopurinol