ESSM Newsletter # 40

15 ESSM Today Hemospermia. What you need to know man or bleeding, such as large bruises (more than 5 cm in diameter) in the absence of injuries and petechiae. It is important to investigate the ab- dominal cavity for the presence of hepatospleno- megaly, which may indicate major hematologic, hepatic, or infectious diseases. Blood pressure should also be measured to detect hypertension. Today, per the results of many studies, the link between persistent or recurrent hemospermia and prostate cancer has been proven. Patients with suspicious lesions detected dur- ing rectal examination of the prostate gland, especially those over 50 years of age (over 45 years of age with a family history), need to determine the level of serum prostate specific antigen (PSA). Performing transrectal ultrasound (TRUS) of the prostate gland allows for a clear visualization of the prostate, seminal vesicles and adjacent structures (detection of calculi, calcinates, cysts, varicose veins of the prostate and inflammatory changes). The effectiveness of this method has been demonstrated in many studies. If it is impossible to identify pathological changes, while maintaining hemospermia, it is necessary to resort to performing magnetic resonance imaging (MRI) - normal or using an endorectal coil, as well as multispiral computed tomography (MSCT) to better visualize the anatomical and functional state of the pelvic organs. It is worth noting the fact that in 70 – 80% of all cases the cause of hemospermia cannot be detected, that is, hemospermia is idiopathic and is of a benign nature of the disease. Nev- ertheless, on the part of the doctor requires further monitoring of such a patient. Modern research methods allow to identify the main cause of most cases of hemospermia, and most patients are subject to conservative treatment. But the main goal of the doctor is to eliminate serious life-threatening condi- tions, such as prostate cancer and bladder cancer, as well as several the diseases already mentioned. It is necessary to explain to the patient that hematospermia is not always associated with a specific disease. In the case of a single episode of hemospermia in such patients under 40 years of age, further observation is sufficient. Middle-aged men with recurrent episodes of hematospermia need more careful observa- tion. If an infection is suspected, even with a negative culture, antibiotic therapy may be prescribed as an empirical treatment. It is worth noting that systemic diseases are to be treated by specialized specialists. Cysts of the prostate or seminal vesicles are aspirated under TRUS control. In the case of recurrent episodes of hemospermia, fibrourethrocyst- oscopy (expanded veins of the prostate gland and urethral anomalies) can make a big contri- bution to making the correct diagnosis. However, in most cases, hemospermia is benign. It is often associated with urogenital infections or inflammatory diseases of the or- gans of the urogenital system. The changes in the seminal vesicles detected during the examination, and thus the hemospermia that occurs, are often also benign. And if, when detecting hemospermia, there is a suspicion of cancer of the prostate gland or seminal vesicles, an ultrasound transrectal biopsy should be performed. Thus, the use of modern research methods al- lows to identify the main cause of most cases of hemospermia. Men with repeated episodes of hemospermia should be constantly moni- tored by a urologist, since hemospermia can be the first sign of prostate cancer in high-risk groups (men over 45 years of age with a family history, as well as in African-American men). Take your Chance – Become a Member of ESSM, now ! Seize the day, or in Latin Carpe diem and become a member of ESSM now, to take all the advantages and benefits of ESSM membership. There are two levels of ESSM member­ ship available: ESSM/ISSM Membership A combined ESSM/ISSM membership (annual fee 160 EUR) for both Sexual Medicine Societies (ESSM/ISSM) inclu­ ding all ESSM and ISSM membership related services, including a subscription to the Journal of Sexual Medicine which is the monthly journal of the ISSM (Inter­ national) and ESSM (European), and is the leading Journal in the field of Sexual Medicine. In addition there are reduced registration fees for all ISSM/ESSM rela­ ted congresses. ESSM only Membership ESSM only membership (annual fee 50 EUR – reduced to 25 EUR for resi­ dents in training) which includes the ESSM official Scientific and Social peri­ odical, the „ESSM Today“, full access to the ESSM website: www.essm.org (including regularly updated scientific material, monthly updated literature re­ views, the most recent guidelines, lecture recordings and presentations from past ESSM congresses), the opportunity to participate in the ESSM educational pro­ grams, and to apply for scientific and sup­ port grants and a reduced fee for the ESSM annual congress. ESSM Annual Membership Fees (January to December) Combined ESSM/ISSM Fee incl. JSM Journal EUR 160 ESSM only Fee EUR 50 ESSM only Residents in Training Fee* EUR 25 *available against proof of evidence See application form on page 27.