Tian Long, Han Hu, Lei Hong-En, Zhang Xiao-Dong
Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Andrologia. 2018 Oct;50(8):e13072. doi: 10.1111/and.13072. Epub 2018 Jun 25.
To compare the clinical features of seminal vesicle calculi(SVC) versus posterior urethral haemangioma(PUH) to assist urologists in differentiating and diagnosing the causes of haematospermia. Patients with SVC or PUH were included. Patient age, disease duration, hospital stay, operation time, symptoms, surgical approach, pathological results and postoperative complications were recorded. A total of seven patients with SVC and 15 patients with PUH involved have an average age of 34.1 and 44.5 years separately. Patients with SVC complained of recurrent haematospermia; patients with PUH complained of recurrent haematospermia and urethral opening bleeding after sexual arousal. SVC manifested as a dark red blood-semen mixture with ejaculation pain and no blood clots; the condition could improve after anti-infective treatment. PUH manifested as no visible blood-semen mixture, bright red semen with blood clots and no ejaculation pain; the condition did not respond to anti-infective treatment. SVC was treated with holmium laser lithotripsy under a transurethral seminal vesiculoscopy. PUH was treated with transurethral resection and fulguration. Postoperative follow-up showed that the clinical symptoms gradually disappeared, with no postoperative complications. Both SVC and PUH can result in recurrent haematospermia. Therefore, urologists should treat haematospermia differently according to the cause.
比较精囊结石（SVC）与后尿道血管瘤（PUH）的临床特征，以协助泌尿外科医生鉴别和诊断血精的病因。纳入患有SVC或PUH的患者。记录患者年龄、病程、住院时间、手术时间、症状、手术方式、病理结果及术后并发症。共纳入7例SVC患者和15例PUH患者，平均年龄分别为34.1岁和44.5岁。SVC患者主诉反复血精；PUH患者主诉反复血精及性唤起后尿道口出血。SVC表现为暗红色血精混合液，伴有射精痛，无血凝块；抗感染治疗后病情可改善。PUH表现为无明显血精混合液，精液呈鲜红色伴有血凝块，无射精痛；抗感染治疗无效。SVC采用经尿道精囊镜钬激光碎石术治疗。PUH采用经尿道切除术及电灼术治疗。术后随访显示临床症状逐渐消失，无术后并发症。SVC和PUH均可导致反复血精。因此，泌尿外科医生应根据病因对血精进行不同的治疗。
