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hematospermia
Etiology:
1) men < 40 years of age
a) benign condition
b) prostatitis
c) urethritis
d) etiology generally not found
2) men > 40 years of age
a) prostatic calculi is the most common cause
b) 10% have a malignancy
Laboratory:
1) urinalysis
2) prostate-specific antigen (PSA) for men > 40 years of age
3) transrectal ultrasound for men > 40 years of age
- not indicated in asymptomatic elderly with isolated occurence [2] or need to exclued prostate cancer or bladder cancer [6]
Management:
1) benign condition in men < 40 years of age
a) reassurance
b) rarely recurs
2) refer patients > 40 years of age to urology for persistent hematuria [4]
- VAMC recommends serum PSA, consult not necessary unless serum PSA elevated [3]
- isolated hematuria in asymptomatic elderly is a benign condition & needs no consult or workup [2,5]
- reassurance & reassessment if recurrent
General
ejaculatory dysfunction
sign/symptom
References
- Medical Knowledge Self Assessment Program (MKSAP) 11, American
College of Physicians, Philadelphia 1998
- Geriatric Review Syllabus, 8th edition (GRS8)
Durso SC and Sullivan GN (eds)
American Geriatrics Society, 2013
- Veterans Administration, Urology, Sacramento CA
- Ahmad I, Krishna NS.
Hemospermia.
J Urol. 2007 May;177(5):1613-8.
PMID: 17437771
- Stefanovic KB, Gregg PC, Soung M.
Evaluation and treatment of hematospermia.
Am Fam Physician. 2009 Dec 15;80(12):1421-7.
PMID: 20000304
- NEJM Knowledge+