Abstract
Hemospermia is known to be associated with transrectal ultrasound-guided prostate biopsy (TRUS-PB). The true incidence of hemospermia, its duration and implications are not well established. We performed a prospective observational study involving patients undergoing TRUS-PB for suspected prostate cancer at our institution. Sixty-three eligible men were included in the study. Most men (84%) undergoing TRUS-PB, who were able to ejaculate, experienced hemospermia, which was associated with some degree of anxiety. The mean duration of hemospermia was 3.5 (±1.7) weeks. The number of ejaculations before the complete resolution of hemospermia was 8 (±6.7). None of the clinical and pathological factors was a significant predictor of the duration of hemospermia. Patients should be adequately counseled before TRUS-PB to avoid undue anxiety and alterations in sexual activity.
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References
Schroder FH, Bangma CH . The European Randomized Study of Screening for Prostate Cancer (ERSPC). Br J Urol 1997; 79 (Suppl 1): 68–71.
Djavan B, Waldert M, Zlotta A, Dobronski P, Seitz C, Remzi M et al. Safety and morbidity of first and repeat transrectal ultrasound guided prostate needle biopsies: results of a prospective European prostate cancer detection study. J Urol 2001; 166: 856–860.
Hodge KK, McNeal JE, Stamey TA . Ultrasound guided transrectal core biopsies of the palpably abnormal prostate. J Urol 1989; 142: 66–70.
Stricker HJ, Ruddock LJ, Wan J, Belville WD . Detection of non-palpable prostate cancer. A mathematical and laboratory model. Br J Urol 1993; 71: 43–46.
Presti Jr JC, Chang JJ, Bhargava V, Shinohara K . The optimal systematic prostate biopsy scheme should include 8 rather than 6 biopsies: results of a prospective clinical trial. J Urol 2000; 163: 163–166; discussion 166–167.
Naughton CK, Ornstein DK, Smith DS, Catalona WJ . Pain and morbidity of transrectal ultrasound guided prostate biopsy: a prospective randomized trial of 6 versus 12 cores. J Urol 2000; 163: 168–171.
Rodriguez LV, Terris MK . Risks and complications of transrectal ultrasound guided prostate needle biopsy: a prospective study and review of the literature. J Urol 1998; 160: 2115–2120.
Aus G, Hermansson CG, Hugosson J, Pedersen KV . Transrectal ultrasound examination of the prostate: complications and acceptance by patients. Br J Urol 1993; 71: 457–459.
Collins GN, Lloyd SN, Hehir M, McKelvie GB . Multiple transrectal ultrasound-guided prostatic biopsies – true morbidity and patient acceptance. Br J Urol 1993; 71: 460–463.
Gustafsson O, Norming U, Nyman CR, Ohstrom M . Complications following combined transrectal aspiration and core biopsy of the prostate. Scand J Urol Nephrol 1990; 24: 249–251.
Thompson PM, Pryor JP, Williams JP, Eyers DE, Dulake C, Scully MF et al. The problem of infection after prostatic biopsy: the case for the transperineal approach. Br J Urol 1982; 54: 736–740.
Thompson PM, Talbot RW, Packham DA, Dulake C . Transrectal biopsy of the prostate and bacteraemia. Br J Surg 1980; 67: 127–128.
Djavan B, Zlotta A, Kratzik C, Remzi M, Seitz C, Schulman CC et al. PSA, PSA density, PSA density of transition zone, free/total PSA ratio, and PSA velocity for early detection of prostate cancer in men with serum PSA 2.5 to 4.0 ng/ml. Urology 1999; 54: 517–522.
Djavan B, Zlotta AR, Byttebier G, Shariat S, Omar M, Schulman CC et al. Prostate specific antigen density of the transition zone for early detection of prostate cancer. J Urol 1998; 160: 411–418; discussion 418–419.
Brawer MK, Chetner MP . Ultrasonography of the Prostate and Biopsy. W.B. Saunders Co: Philadelphia, 1998, pp 2506–2518.
Djavan B, Zlotta A, Remzi M, Ghawidel K, Basharkhah A, Schulman CC et al. Optimal predictors of prostate cancer on repeat Prostate Biopsy: a prospective study of 1051 men. J Urol 2000; 163: 1144–1148; discussion 1148–1149.
Munkel witz R, Krasnokutsky S, Lie J, Shah SM, Bayshtok J, Khan SA . Current perspectives on hematospermia: a review. J Androl 1997; 18: 6–14.
Kumar P, Kapoor S, Nargund V . Haematospermia – a systematic review. Ann R Coll Surg Engl 2006; 88: 339–342.
Han M, Brannigan RE, Antenor JA, Roehl KA, Catalona WJ . Association of hemospermia with prostate cancer. J Urol 2004; 172: 2189–2192.
Bihrle R, Foster RS, Sanghvi NT, Donohue JP, Hood PJ . High intensity focused ultrasound for the treatment of benign prostatic hyperplasia: early United States clinical experience. J Urol 1994; 151: 1271–1275.
Jones DJ . Haemospermia: a prospective study. Br J Urol 1991; 67: 88–90.
Torp-Pedersen S, Lee F, Littrup PJ, Siders DB, Kumasaka GH, Solomon MH et al. Transrectal biopsy of the prostate guided with transrectal US: longitudinal and multiplanar scanning. Radiology 1989; 170: 23–27.
de la Taille A, Antiphon P, Salomon L, Cherfan M, Porcher R, Hoznek A et al. Prospective evaluation of a 21-sample needle biopsy procedure designed to improve the prostate cancer detection rate. Urology 2003; 61: 1181–1186.
Mkinen T, Auvinen A, Hakama M, Stenman UH, Tammela TL . Acceptability and complications of prostate biopsy in population-based PSA screening versus routine clinical practice: a prospective, controlled study. Urology 2002; 60: 846–850.
Rietbergen JB, Kruger AE, Kranse R, Schroder FH . Complications of transrectal ultrasound-guided systematic sextant biopsies of the prostate: evaluation of complication rates and risk factors within a population-based screening program. Urology 1997; 49: 875–880.
Clements R, Aideyan OU, Griffiths GJ, Peeling WB . Side effects and patient acceptability of transrectal biopsy of the prostate. Clin Radiol 1993; 47: 125–126.
Ghani KR, Dundas D, Patel U . Bleeding after transrectal ultrasonography-guided prostate biopsy: a study of 7-day morbidity after a six-, eight- and 12-core biopsy protocol. BJU Int 2004; 94: 1014–1020.
Wammack R, Djavan B, Remzi M, Susani M, Marberger M . Morbidity of transrectal ultrasound-guided prostate needle biopsy in patients receiving immunosuppression. Urology 2001; 58: 1004–1007.
Maan Z, Cutting CW, Patel U, Kerry S, Pietrzak P, Perry MJ et al. Morbidity of transrectal ultrasonography-guided prostate biopsies in patients after the continued use of low-dose aspirin. BJU Int 2003; 91: 798–800.
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This work was financially supported by Jackson Memorial Hospital Foundation and Mr Vincent A Rodriguez.
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Manoharan, M., Ayyathurai, R., Nieder, A. et al. Hemospermia following transrectal ultrasound-guided prostate biopsy: a prospective study. Prostate Cancer Prostatic Dis 10, 283–287 (2007). https://doi.org/10.1038/sj.pcan.4500955
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DOI: https://doi.org/10.1038/sj.pcan.4500955
Keywords
- hemospermia
- prostate biopsy
- transrectal ultrasound
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