Department of Urology, Ayr Hospital, Ayr, UK.
Int J Clin Pract. 2010 Sep;64(10):1436-9. doi: 10.1111/j.1742-1241.2009.02242.x.
This study is a ten-year single institution retrospective study of patients presenting with haematospermia, to establish standard tests for investigation, and what tests have low yield and can be omitted.
Investigations that were used were analysed to establish their diagnostic yield. The parameters examined were: digital rectal examination (DRE) findings, prostate specific antigen (PSA), abdominal and scrotal ultrasound, TRUS biopsy result (wherever applicable), flexible cystoscopy findings and final diagnosis.
The central findings were that abdominal ultrasound never yielded an abnormality and that flexible cystoscopy never showed bladder tumours. TRUS prostate biopsies were performed in 17% of patients, and prostate cancer was confirmed in 5% of patients. Testicular malignancy was found in 2%. In 90% of patients, no specific diagnosis was made, and 85% of patients were discharged at review.
A single episode of haematospermia is usually benign. Flexible cystoscopy and abdominal ultrasound appear valueless. Assessment should consist of clinical examination (including testicular), DRE and PSA testing. It can safely be managed in the community and only referred in the presence of, abnormal examination, elevated PSA or recurrent symptoms.
本研究是对出现血精的患者进行的一项为期十年的单机构回顾性研究，旨在确定用于检查的标准检测方法，并确定哪些检测方法的检出率较低，可以省略。
对使用的检查方法进行了分析，以确定其诊断效果。检查的参数包括：直肠指检（DRE）结果、前列腺特异抗原（PSA）、腹部和阴囊超声、经直肠超声引导前列腺活检结果（如适用）、软性膀胱镜检查结果和最终诊断。
主要发现是腹部超声从未发现异常，软性膀胱镜检查从未发现膀胱癌。17%的患者进行了经直肠超声引导前列腺活检，5%的患者被确诊为前列腺癌。2%的患者发现睾丸恶性肿瘤。90%的患者未明确诊断，85%的患者在复诊时出院。
单次血精通常是良性的。软性膀胱镜和腹部超声似乎没有价值。评估应包括临床检查（包括睾丸）、DRE 和 PSA 检测。在检查异常、PSA 升高或症状复发的情况下，可以安全地在社区进行管理，仅在这些情况下进行转诊。
