title: An Unusual Etiology for Hematospermia and Treatments That Were Successful.
abstract: OBJECTIVE
  To describe the unusual etiology and effective treatments of intractable hematospermia from posterior urethral hemangioma.
  
  
  METHODS
  The ages, disease duration, syndromes, urinary routine, pathologic findings, immunohistochemical staining results, and postoperative complications of 5 patients were recorded. Four patients had a transurethral resection for total removal of lesions, and 1 patient was treated with transurethral fulguration.
  
  
  RESULTS
  The 5 patients involved were middle aged with an average age of 46.2 years and average disease duration of 8.8 years. The clinical features of their hematospermia were as follows: break outs repeatedly after ejaculation in large quantities, no obvious mixing with the seminal plasma, urine after the first ejaculation or second in the morning is hematuria and is even accompanied by blood clots, and urethrorrhagia after sexual excitation, and there is no significant effect of various positive anti-inflammatory treatments. Cystourethroscopy found that the solitary varicosities were located between the distal end of the verumontanum and the external urethral sphincter. The varicose lesion was removed by transurethral resection for posterior urethral lesions, and the surrounding tissue was removed with fulguration. Vessel formation was confirmed by CD31 and CD34 immunohistochemical staining. Finally, the presence of posterior urethral hemangioma was verified in 4 patients by pathologic examination combined with immunohistochemistry, but 1 patient did not have any specimens available.
  
  
  CONCLUSIONS
  The possibility of posterior urethral hemangioma should be considered for patients with repeated intractable hematospermia. Cystourethroscopy is recommended for examination throughout patient services, and transurethral resection, fulguration, or laser cutting methods can also be performed.
authors.affiliation: Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
authors.forename: Hu
authors.initials: H
authors.lastname: Han
authors.affiliation: Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
authors.forename: Xiao-Guang
authors.initials: XG
authors.lastname: Zhou
authors.affiliation: Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
authors.forename: Dong-Dong
authors.initials: DD
authors.lastname: Fan
authors.affiliation: Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
authors.forename: Long
authors.initials: L
authors.lastname: Tian
authors.affiliation: Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China. Electronic address: zxd581@263.net.
authors.forename: Xiao-Dong
authors.initials: XD
authors.lastname: Zhang
mesh_terms: D000328:Adult; D019468:Disease Management; D006391:Hemangioma / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D051516:Hemospermia / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D018666:Ureteroscopy; D014523:Urethral Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D013521:Urologic Surgical Procedures, Male / Q000379:methods*