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. 2010 Mar;13(1):28-33.
doi: 10.1016/j.jus.2009.09.005. Epub 2009 Oct 12.

Transrectal ultrasound in patients with hematospermia

A A K A Razek  1 , S Elhanbly, A Eldeak
Affiliations

Transrectal ultrasound in patients with hematospermia

A A K A Razek et al. J Ultrasound. 2010 Mar.

Abstract
in English, Italian

Introduction: To illustrate the lesions detected with transrectal ultrasound (TRUS) in patients with hematospermia.

Material and methods: This study included 74 male patients (25-73 years old) affected by hematospermia. Clinical history was obtained and all patients underwent rectal examination as well as TRUS examination in both axial and coronal planes to evaluate the prostate, ejaculatory ducts and seminal vesicles. Biopsy was performed in 10 patients.

Results: Abnormalities were detected in 59 patients. Calculi (n = 20) were seen within the prostate, seminal vesicles and along the course of the ejaculatory ducts. Chronic prostatitis (n = 14) appeared as hyperechoic and hypoechoic areas within the prostate with capsule thickening suggesting seminal vesiculitis (n = 8). Granulomatous prostatitis (n = 3) appeared as hyperechoic and calcified areas scattered within the prostate and the seminal vesicles. Hypoechoic focal lesions and heterogeneous texture were seen in prostate cancer (n = 5). Utricular cysts (n = 3) appeared as small midline lesions, and Mullerian duct cysts (n = 8) appeared as larger midline cysts protruding above the prostate. Ejaculatory duct cysts (n = 4) appeared as thick walled cystic lesions along the course of the ejaculatory duct. Seminal vesicle cysts were detected in 2 patients.

Conclusion: Our conclusion is that TRUS is a safe, non-invasive technique which can be used to detect lesions of the prostate, seminal vesicles and the ejaculatory ducts in patients with hematospermia.

Sommario INTRODUZIONE: Illustrare le lesioni identificate con ecografia prostatica transrettale in pazienti con ematospermia. MATERIALI E METODI: Il presente studio include 74 pazienti di sesso maschile (25–73 anni) con ematospermia. Tutti i pazienti successivamente sono stati sottoposti a esame ecografico prostatico transrettale sui piani assiale e coronale della prostata, dei dotti eiaculatori e delle vescichette seminali dopo aver effettuato l'anamnesi e l'esplorazione rettale. La biopsia è stata effettuata in 10 pazienti. RISULTATI: In 59 pazienti sono stati identificati reperti patologici. Calcoli (n = 20) sono stati identificati entro il parenchima ghiandolare prostatico, nelle vescichette seminali e lungo il decorso dei dotti eiaculatori. La prostatite cronica (n = 14) si presentava con un'immagine iperecogena con aree ipoecogene del parenchima ghiandolare con ispessimento della capsula che si associava con vesciculite seminale (n = 8). La prostatite granulomatosa (n = 3) appariva iperecogena con alcune regioni calcifiche distribuite nella prostata e nelle vescichette seminali. Nei casi di tumore della prostata sono stati identificate lesioni focali ipoecogene e ecostruttura eterogenea (n = 5). La cisti utriculare (n = 3) era una lesione della linea mediana e le cisti dei Dotti Mulleriani (n = 8) apparivano come una cisti della linea centrale più grande che protrudeva sopra la prostata. Le cisti dei dotti eiaculatori (n = 4) apparivano come lesioni con pareti ispessite lungo il decorso del dotto eiaculatorio e le cisti vescicali sono state identificate in 2 pazienti. CONCLUSIONI: Concludiamo che l'ecografia transrettale è una tecnica non invasiva che può essere usata per identificare lesioni della prostata, delle vescichette seminali e dei dotti eiaculatori in pazienti con ematospermia.

Keywords: Hematospermia; Prostatitis; Ultrasound.

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Figures

Fig. 1
Fig. 1
Calculi of the prostate. Axial TRUS image shows two calculi with bright echogenic texture and posterior acoustic shadow in both ejaculatory ducts.
Fig. 2
Fig. 2
Chronic prostatitis. (A) Axial TRUS image shows multiple discrete hyperechoic areas in the periurethral region associated with dilated and thickened wall of the ejaculatory duct. (B) Axial TRUS image demonstrates mildly enlarged seminal vesicles with a few discrete hyperechoic regions.
Fig. 3
Fig. 3
Chronic prostatitis. Axial TRUS image shows a hypoechoic area within the periurethral region.
Fig. 4
Fig. 4
Tuberculous prostatitis. Axial TRUS image shows multiple discrete hyperechoic areas and multiple discrete areas of calcification scattered within the prostate.
Fig. 5
Fig. 5
Cancer prostate. Axial TRUS image shows multiple discrete hypoechoic focal lesions scattered within the prostate mainly in the peripheral zone.
Fig. 6
Fig. 6
Utricular cyst. Axial TRUS image shows a small sized, tubular, thin walled midline cyst.
Fig. 7
Fig. 7
Mullerian duct cyst. Axial TRUS image shows awell-defined, large, thin walled midline cyst. (B) Sagittal midline TRUS image shows that the cyst has a cone-shaped appearance.
Fig. 8
Fig. 8
Ejaculatory duct cyst. Axial TRUS image shows a thick walled cyst located along the course of the ejaculatory duct slightly off the midline.
See this image and copyright information in PMC

References

    1. Ahmad I., Krishna N. Hemospermia. J Urol. 2007;177:1613–1618. - PubMed
    1. Kumar P., Kapoor S., Nargund V. Hematospermia – a systematic review. Ann R Coll Surg Engl. 2006;88:339–342. - PMC - PubMed
    1. Munkelwitz R., Krasnokutsky S., Lie J., Shah S.M., Bayshtok J., Khan S.A. Current perspectives on hematospermia: a review. J Androl. 1997;18:6–14. - PubMed
    1. Torigian D.A., Ramchandani P. Hematospermia: imaging findings. Abdom Imaging. 2007;32:29–49. - PubMed
    1. Maeda H., Toyooka N., Kinukawa T., Hattori R., Furukawa T. Magnetic resonance images of haematospermia. Urology. 1993;41:499–504. - PubMed

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