{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T10:21:22Z","timestamp":1778149282111,"version":"3.51.4"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2019,3,22]],"date-time":"2019-03-22T00:00:00Z","timestamp":1553212800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2019,3,22]],"date-time":"2019-03-22T00:00:00Z","timestamp":1553212800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>To investigate the surgical outcomes of vesiculoscopy on refractory hematospermia and ejaculatory duct obstruction (EDO), the clinical data (including pelvic magnetic resonance imaging (MRI) examinations and the long-term effects of endoscopic treatment) from 305 patients were analyzed. Four main etiologic groups were found on MRI. We found that 62.0% (189\/305) of patients showed abnormal signal intensity in MRI investigations in the seminal vesicle (SV) area. Cystic lesions were observed in 36.7% (112\/305) of the patients. The third sign was dilatation or enlargement of unilateral or bilateral SV, which were observed in 32.1% (98\/305) of the patients. The fourth sign was stone formation in SV or in an adjacent cyst, which was present in 8.5% (26\/305) of the patients. The transurethral endoscopy or seminal vesiculoscopy and the related procedures, including fenestration in prostatic utricle (PU), irrigation, lithotripsy, stone removal, biopsy, electroexcision, fulguration, or transurethral resection\/incision of the ejaculatory duct (TURED\/TUIED), chosen according to the different situations of individual patients were successfully performed in 296 patients. Fenestrations in PU+ seminal vesiculoscopy were performed in 66.6% (197\/296) of cases. Seminal vesiculoscopy via the pathological opening in PU was performed in 10.8% (32\/296) of cases. TURED\/TUIED\u2009+\u2009seminal vesiculoscopy was performed in 12.8% (38\/296) of cases, and seminal vesiculoscopy by the natural orifices of the ejaculatory duct (ED) was performed in 2.4% (7\/296) of cases. Electroexcision and fulguration to the abnormal blood vessels or cavernous hemangioma at posterior urethra were performed in 7.4% (22\/296) of cases. Two hundred and seventy-one patients were followed up for 6\u201372 months. The hematospermia of all the patients disappeared within 2\u20136 weeks, and 93.0% of the patients showed no further hematospermia during follow-up. No obvious postoperative complications were observed. The transurethral seminal vesiculoscopy technique and related procedures are safe and effective approaches for refractory hematospermia and EDO.<\/jats:p>","DOI":"10.1038\/s41598-019-41123-2","type":"journal-article","created":{"date-parts":[[2019,3,22]],"date-time":"2019-03-22T11:03:26Z","timestamp":1553252606000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Etiology of 305 cases of refractory hematospermia and therapeutic options by emerging endoscopic technology"],"prefix":"10.1038","volume":"9","author":[{"given":"Liang-Gong","family":"Liao","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan-Feng","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ke","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tong","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bo-Jun","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qi","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xu-Dong","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong","family":"Luo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bo","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9408-2972","authenticated-orcid":false,"given":"Jun","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2019,3,22]]},"reference":[{"key":"41123_CR1","doi-asserted-by":"publisher","first-page":"463","DOI":"10.1016\/S0090-4295(99)80256-8","volume":"46","author":"JP Mulhall","year":"1995","unstructured":"Mulhall, J. P. & Albertsen, P. C. Hemospermia: diagnosis and management. Urology. 46, 463\u2013467 (1995).","journal-title":"Urology."},{"key":"41123_CR2","doi-asserted-by":"publisher","first-page":"2189","DOI":"10.1097\/01.ju.0000144565.76243.b1","volume":"172","author":"M Han","year":"2004","unstructured":"Han, M. et al. Association of hemospermia with prostate cancer. J Urol. 172, 2189\u20132192 (2004).","journal-title":"J Urol."},{"key":"41123_CR3","first-page":"82","volume":"78","author":"M Polito","year":"2006","unstructured":"Polito, M. et al. Hematospermia: diagnosis and treatment. Arch Ital Urol Androl. 78, 82\u201385 (2006).","journal-title":"Arch Ital Urol Androl."},{"key":"41123_CR4","doi-asserted-by":"publisher","first-page":"959","DOI":"10.21037\/tau.2017.06.01","volume":"6","author":"Y Suh","year":"2017","unstructured":"Suh, Y. et al. Etiologic classification, evaluation, and management of hematospermia. Transl Androl Urol. 6, 959\u2013972 (2017).","journal-title":"Transl Androl Urol."},{"key":"41123_CR5","doi-asserted-by":"publisher","first-page":"948","DOI":"10.1111\/j.2047-2927.2013.00132.x","volume":"1","author":"BJ Li","year":"2013","unstructured":"Li, B. J. et al. Clinical analysis of the characterization of magnetic resonance imaging in 102 cases of refractory haematospermia. Andrology. 1, 948\u2013956 (2013).","journal-title":"Andrology."},{"key":"41123_CR6","doi-asserted-by":"publisher","first-page":"438","DOI":"10.4103\/aja.aja_76_17","volume":"20","author":"R Chen","year":"2018","unstructured":"Chen, R. et al. Transurethral seminal vesiculoscopy for recurrent hemospermia: experience from 419 cases. Asian J Androl. 20, 438\u2013441 (2018).","journal-title":"Asian J Androl."},{"key":"41123_CR7","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1177\/0300060513509472","volume":"42","author":"B Liu","year":"2014","unstructured":"Liu, B. et al. Transurethral seminal vesiculoscopy in the diagnosis and treatment of intractable seminal vesiculitis. J Int Med Res. 42, 236\u2013242 (2014).","journal-title":"J Int Med Res."},{"key":"41123_CR8","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1007\/s12522-011-0087-4","volume":"10","author":"H Fuse","year":"2011","unstructured":"Fuse, H. et al. Hematospermia: etiology, diagnosis, and treatment. Reproductive Medicine and Biology. 10, 153\u2013159 (2011).","journal-title":"Reproductive Medicine and Biology."},{"key":"41123_CR9","doi-asserted-by":"publisher","first-page":"1613","DOI":"10.1016\/j.juro.2007.01.004","volume":"177","author":"I Ahmad","year":"2007","unstructured":"Ahmad, I. & Krishna, N. S. Hemospermia. J Urol 177, 1613\u20131618 (2007).","journal-title":"J Urol"},{"key":"41123_CR10","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1038\/ijir.2013.40","volume":"26","author":"J Zargooshi","year":"2014","unstructured":"Zargooshi, J. et al. Hemospermia: long-term outcome in 165 patients. Int J Impot Res 26, 83\u201386 (2014).","journal-title":"Int J Impot Res"},{"key":"41123_CR11","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1007\/s11255-008-9409-9","volume":"41","author":"DE Leocadio","year":"2009","unstructured":"Leocadio, D. E. & Stein, B. S. Hematospermia: etiological and management considerations. Int Urol Nephrol 41, 77\u201383 (2009).","journal-title":"Int Urol Nephrol"},{"key":"41123_CR12","first-page":"907","volume":"44","author":"N Dantanarayana","year":"2015","unstructured":"Dantanarayana, N. Haematospermia. Aust Fam Physician 44, 907\u2013910 (2015).","journal-title":"Aust Fam Physician"},{"key":"41123_CR13","first-page":"186","volume":"114","author":"MJ Mathers","year":"2017","unstructured":"Mathers, M. J. et al. Hematospermia-a Symptom with Many Possible Causes. Deutsches \u00c4rzteblatt International 114, 186 (2017).","journal-title":"Deutsches \u00c4rzteblatt International"},{"key":"41123_CR14","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1016\/j.surge.2012.04.004","volume":"11","author":"YH Ng","year":"2013","unstructured":"Ng, Y. H., Seeley, J. P. & Smith, G. Haematospermia as a presenting symptom: outcomes of investigation in 300 men. Surgeon Journal of the Royal Colleges of Surgeons of Edinburgh & Ireland 11, 35\u201338 (2013).","journal-title":"Surgeon Journal of the Royal Colleges of Surgeons of Edinburgh & Ireland"},{"key":"41123_CR15","doi-asserted-by":"publisher","first-page":"1373","DOI":"10.1148\/rg.2016150195","volume":"36","author":"PK Mittal","year":"2016","unstructured":"Mittal, P. K. et al. Hematospermia Evaluation at MR Imaging. Radiographics 36, 1373\u20131389 (2016).","journal-title":"Radiographics"},{"key":"41123_CR16","doi-asserted-by":"publisher","first-page":"838","DOI":"10.1016\/j.urology.2008.05.058","volume":"72","author":"S Furuya","year":"2008","unstructured":"Furuya, S. et al. Magnetic resonance imaging is accurate to detect bleeding in the seminal vesicles in patients with hemospermia. Urology 72, 838\u2013842 (2008).","journal-title":"Urology"},{"key":"41123_CR17","doi-asserted-by":"publisher","first-page":"906","DOI":"10.2164\/jandrol.111.015487","volume":"33","author":"YF Li","year":"2012","unstructured":"Li, Y. F. et al. Imaging diagnosis, transurethral endoscopic observation, and management of 43 cases of persistent and refractory hematospermia. J Androl 33, 906\u2013916 (2012).","journal-title":"J Androl"},{"key":"41123_CR18","first-page":"1","volume":"51","author":"M Christodoulidou","year":"2017","unstructured":"Christodoulidou, M., Parnham, A. & Nigam, R. Diagnosis and management of symptomatic seminal vesicle calculi. Scand J Urol 51, 1\u20138 (2017).","journal-title":"Scand J Urol"},{"key":"41123_CR19","doi-asserted-by":"publisher","first-page":"1052","DOI":"10.1097\/00029330-200806010-00017","volume":"121","author":"XR Zhang","year":"2008","unstructured":"Zhang, X. R. et al. Transrectal ultrasonography-guided transperineal bilateral seminal vesicle puncture and continuous irrigation for the treatment of intractable hematospermia. Chin Med J (Engl) 121, 1052\u20131054 (2008).","journal-title":"Chin Med J (Engl)"},{"key":"41123_CR20","doi-asserted-by":"publisher","first-page":"e1128","DOI":"10.1016\/S1569-9056(16)61129-6","volume":"5","author":"YF Li","year":"2016","unstructured":"Li, Y. F. & Liao, L. G. The application of vesiculoscopy in the patients of hematospermia and ejaculatory duct obstruction (216 cases report). European Urology Supplements 5, e1128 (2016).","journal-title":"European Urology Supplements"},{"key":"41123_CR21","doi-asserted-by":"publisher","first-page":"851","DOI":"10.1007\/s12013-013-9527-6","volume":"66","author":"CH Han","year":"2013","unstructured":"Han, C. H. et al. The transurethral seminal vesiculoscopy in the diagnosis and treatment of the seminal vesicle disease. Cell Biochem Biophys 66, 851\u2013853 (2013).","journal-title":"Cell Biochem Biophys"},{"key":"41123_CR22","doi-asserted-by":"publisher","first-page":"147","DOI":"10.4103\/1008-682X.156856","volume":"18","author":"SX Zeng","year":"2016","unstructured":"Zeng, S. X. et al. The feasibility and experience of using seminal vesiculoscopy in the diagnosis of primary seminal vesicle tumors. Asian Journal of Andrology 18, 147\u2013148 (2016).","journal-title":"Asian Journal of Andrology"},{"key":"41123_CR23","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1089\/089277902760261347","volume":"16","author":"SC Yang","year":"2002","unstructured":"Yang, S. C. et al. Transutricular seminal vesiculoscopy. J Endourol 16, 343\u2013345 (2002).","journal-title":"J Endourol"},{"key":"41123_CR24","doi-asserted-by":"publisher","first-page":"1377","DOI":"10.1016\/j.urology.2008.07.038","volume":"73","author":"WK Han","year":"2009","unstructured":"Han, W. K. et al. Transutricular seminal vesiculoscopy in hematospermia: technical considerations and outcomes. Urology 73, 1377\u20131382 (2009).","journal-title":"Urology"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-019-41123-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-019-41123-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-019-41123-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,17]],"date-time":"2022-12-17T08:07:08Z","timestamp":1671264428000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-019-41123-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3,22]]},"references-count":24,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2019,12]]}},"alternative-id":["41123"],"URL":"https:\/\/doi.org\/10.1038\/s41598-019-41123-2","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,3,22]]},"assertion":[{"value":"16 May 2018","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 February 2019","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 March 2019","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing Interests"}}],"article-number":"5018"}}