Abstract

Hematospermia is a relatively uncommon condition in urological practice and is usually benign and self- limiting. However, persistent or recurrent cases may be associated with underlying structural abnormalities such as chronic inflammation, ejaculatory duct obstruction, or seminal vesicle stones, posing challenges in diagnosis and management. This review aims to summarize the etiology, diagnostic approaches, and management strategies of hematospermia, with a particular focus on the role of transurethral seminal vesiculoscopy (TUSV). Relevant literature was collected from both domestic and international sources regarding hematospermia and TUSV, and was complemented by a case series of six patients treated at Hue University of Medicine and Pharmacy Hospital. Imaging modalities such as transrectal ultrasound and magnetic resonance imaging provide valuable initial assessment but remain limited in accurately identifying the underlying cause. TUSV enables direct visualization of the seminal vesicles and ejaculatory ducts, allowing for the detection of intraluminal abnormalities such as bleeding, calculi, and obstruction, while simultaneously facilitating therapeutic intervention. In our case series, all patients underwent TUSV safely, with complete symptom resolution in 83.3% and significant improvement in 16.7%, without any reported complications. Current evidence suggests that TUSV is increasingly recognized as a minimally invasive technique with both 330 TẠP CHÍ Y DƯỢC HUẾ - HUE JOURNAL OF MEDICINE AND PHARMACY ISSN 3030-4318; eISSN: 3030-4326 diagnostic and therapeutic value in managing intractable hematospermia. A thorough understanding of pelvic anatomy and appropriate patient selection are essential to optimize clinical outcomes.