Hematospermia is rarely associated with urologic malignancy: Analysis of United States claims data.
Andrology
; 10(5): 919-925, 2022 07.
Article
em En
| MEDLINE
| ID: mdl-35483126
ABSTRACT
BACKGROUND:
Hematospermia is an alarming symptom and can cause significant patient distress, but work-up is often negative.OBJECTIVE:
To characterize the clinical evaluation of hematospermia and its association with the diagnosis of urologic malignancy. MATERIALS ANDMETHODS:
Using MarketScan insurance claims database, we identified adult males 18-64 years old diagnosed with hematospermia from 2010 to 2018. Benign hematospermia was defined as the absence of hematuria and elevated prostate-specific antigen. Patients with urologic cancer prior to diagnosis of hematospermia were excluded. We identified those who were diagnosed with a urologic malignancy.RESULTS:
The annual average incidence rate of hematospermia was 56.6 per 100,000 (95% confidence interval 55.4-57.8 per 100,000) in 2010 and increased to 73.6 per 100,000 (95% confidence interval 71.7-75.4 per 100,000) in 2018. A total of 56,157 patients presented with benign hematospermia. Most (57.5%) underwent at least one test, with the most common being urinalysis (51.7%), followed by prostate-specific antigen testing (11.9%). All other tests were performed in less than 3% of patients. Forty-seven patients were diagnosed with a urologic cancer, including 28 with prostate cancer (0.05%), nine with testicular cancer (0.016%), six with prostate carcinoma in situ (0.01%), and four with bladder cancer (0.007%). Stratified by age, there was only one cancer diagnosis (testicular) in 15,106 patients under 40 years (0.01%) and 46 cancer diagnoses in 40,611 patients 40 years old or above (0.11%). The median age of patients diagnosed with cancer was 56 years (interquartile range 52-61). DISCUSSION ANDCONCLUSION:
A small minority of patients with benign hematospermia were later diagnosed with urologic cancer in a large nationally representative sample. After excluding hematuria with urinalysis, physicians should conservatively manage and reassure patients with hematospermia, especially those under 40 years of age.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Neoplasias da Próstata
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Neoplasias Testiculares
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Neoplasias Urológicas
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Hemospermia
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article