Munkel witz R, Krasnokutsky S, Lie J, Shah S M, Bayshtok J, Khan S A
Department of Urology, SUNY at Stony Brook 11794-8093, USA.
J Androl. 1997 Jan-Feb;18(1):6-14.
Hematospermia is a disconcerting symptom that produces extreme anxiety in sexually active male patients. To understand the pathophysiology of hematospermia, the anatomy of the ejaculatory system and neurophysiology of emission and ejaculation is essential. Emission and ejaculation must be present for hematospermia to occur. Hematospermia may be the result of inflammation, infection, ductal obstruction or cysts, neoplasms, vascular abnormalities, and systemic or iatrogenic factors. Most patients promptly consult a urologist after an episode of hematospermia. History and physical examination are often unrevealing and the judicious use of imaging modalities, such as transrectal ultrasound, MRI, and rigid or flexible endoscopy may be diagnostic. Unless the specific etiology is defined, most cases are managed expectantly. We review the etiology of hematospermia and an algorithm is provided for the diagnosis and management.
血精症是一种令人不安的症状，会给性活跃的男性患者带来极度焦虑。为了解血精症的病理生理学，射精系统的解剖结构以及射精和排精的神经生理学至关重要。血精症的发生必须有射精和排精过程。血精症可能是由炎症、感染、导管阻塞或囊肿、肿瘤、血管异常以及全身性或医源性因素引起的。大多数患者在出现一次血精症后会立即咨询泌尿科医生。病史和体格检查往往无明显异常，明智地使用经直肠超声、磁共振成像以及硬性或软性内镜等影像学检查手段可能有助于诊断。除非明确具体病因，大多数病例采取观察等待的处理方式。我们回顾了血精症的病因，并提供了一个诊断和处理的流程。
