Abstract：
Hematospermia (HS) is the presence of blood in ejaculatory fluid. It is a rare condition that is historically idiopathic or associated with sexual behavior. Technological advances have identified many of the etiologies behind HS, improving treatment. Though often benign, HS remains a source of considerable sexual anxiety for patients. Few papers have outlined a diagnostic and therapeutic approach to HS, and none have explicitly addressed its sexual consequences.
To provide a comprehensive overview of HS, emphasizing its sexual ramifications.
A PubMed literature search was performed through May 2021 to identify all relevant publications related to etiology, diagnosis, treatment, and sexual effects of HS. Original research and reviews were analyzed, and pertinent studies were included in this review.
Iatrogenic interventions (eg, transrectal ultrasound-guided prostate biopsies) are the most common cause of HS. Infection and/or nonspecific inflammation is the most common non-iatrogenic etiology. Malignancies, including prostate, testicular, and other genitourinary cancers, are rarely the cause of HS. Diagnostic approaches to HS can be organized according to patient age (less than or greater than 40 years old), persistence of bleeding, and the presence/absence of concerning symptoms. Though HS often spontaneously resolves, treatment may require various medications (eg, antibiotics, anti-inflammatories) or surgical interventions. HS has several sexual ramifications, including libido-affecting anxiety, social repercussions from sexual partners and non-sexual affiliates, increased risk of erectile dysfunction or transmission of sexual infections, and compromised fertility, especially when cryopreservation is utilized.
HS may significantly affect sexual health through several mechanisms, though there is a paucity of formal data on this subject. Further research is needed to fully understand the severity and extent of HS\'s effect on sexual well-being, especially in those with refractory bleeding.
To provide a comprehensive overview of HS, emphasizing its sexual ramifications.
A PubMed literature search was performed through May 2021 to identify all relevant publications related to etiology, diagnosis, treatment, and sexual effects of HS. Original research and reviews were analyzed, and pertinent studies were included in this review.
Iatrogenic interventions (eg, transrectal ultrasound-guided prostate biopsies) are the most common cause of HS. Infection and/or nonspecific inflammation is the most common non-iatrogenic etiology. Malignancies, including prostate, testicular, and other genitourinary cancers, are rarely the cause of HS. Diagnostic approaches to HS can be organized according to patient age (less than or greater than 40 years old), persistence of bleeding, and the presence/absence of concerning symptoms. Though HS often spontaneously resolves, treatment may require various medications (eg, antibiotics, anti-inflammatories) or surgical interventions. HS has several sexual ramifications, including libido-affecting anxiety, social repercussions from sexual partners and non-sexual affiliates, increased risk of erectile dysfunction or transmission of sexual infections, and compromised fertility, especially when cryopreservation is utilized.
HS may significantly affect sexual health through several mechanisms, though there is a paucity of formal data on this subject. Further research is needed to fully understand the severity and extent of HS\'s effect on sexual well-being, especially in those with refractory bleeding.
摘要：
背景：血精症（HS）是射精液中存在血液。这是一种罕见的疾病，是历史上特发性或与性行为有关。技术进步已经确定了HS背后的许多病因，改善治疗。虽然通常是良性的，HS仍然是患者严重性焦虑的来源。很少有论文概述了HS的诊断和治疗方法，没有人明确解决它的性后果。
目的：为全面概述HS，强调它的性后果。
方法：到2021年5月进行了PubMed文献检索，以确定与病因学相关的所有相关出版物，诊断,治疗,和HS的性影响。对原始研究和评论进行了分析，相关研究纳入本综述.
结果：医源性干预措施（例如，经直肠超声引导下的前列腺活检）是HS的最常见原因。感染和/或非特异性炎症是最常见的非医源性病因。恶性肿瘤,包括前列腺,睾丸,和其他泌尿生殖系统癌症，很少是HS的原因。可以根据患者年龄（小于或大于40岁）组织HS的诊断方法，持续出血，以及相关症状的存在/不存在。尽管HS经常自发解决，治疗可能需要各种药物(例如，抗生素,抗炎药)或手术干预。HS有几个性影响，包括影响性欲的焦虑，性伴侣和非性附属机构的社会影响，勃起功能障碍或性传播感染的风险增加，生育能力受损，特别是当使用冷冻保存时。
结论：HS可能通过多种机制显著影响性健康，尽管关于这个问题的正式数据很少。需要进一步的研究来充分了解HS对性生活的影响的严重程度和程度，尤其是那些顽固性出血的患者.
目的：为全面概述HS，强调它的性后果。
方法：到2021年5月进行了PubMed文献检索，以确定与病因学相关的所有相关出版物，诊断,治疗,和HS的性影响。对原始研究和评论进行了分析，相关研究纳入本综述.
结果：医源性干预措施（例如，经直肠超声引导下的前列腺活检）是HS的最常见原因。感染和/或非特异性炎症是最常见的非医源性病因。恶性肿瘤,包括前列腺,睾丸,和其他泌尿生殖系统癌症，很少是HS的原因。可以根据患者年龄（小于或大于40岁）组织HS的诊断方法，持续出血，以及相关症状的存在/不存在。尽管HS经常自发解决，治疗可能需要各种药物(例如，抗生素,抗炎药)或手术干预。HS有几个性影响，包括影响性欲的焦虑，性伴侣和非性附属机构的社会影响，勃起功能障碍或性传播感染的风险增加，生育能力受损，特别是当使用冷冻保存时。
结论：HS可能通过多种机制显著影响性健康，尽管关于这个问题的正式数据很少。需要进一步的研究来充分了解HS对性生活的影响的严重程度和程度，尤其是那些顽固性出血的患者.
