V3-10: Step-by-step Laparoscopic Vesiculectomy for Hemospermia

V3-10: Step-by-step Laparoscopic Vesiculectomy for Hemospermia



The definition of hemospermia is the presence of blood in ejaculate. It has been considered as a benign and self-limiting condition. It usually has an inflammatory or infectious cause. However, often raises considerable anxiety to the patient. _x000D_ Recurrent or persistent hemospermia are also associated to more serious underlying pathologies, especially in patients over 40 years of age. Such patients should be referred to an urologist for evaluation._x000D_ A biopsy or a surgical excision are indicated in cases of suspicious findings during investigation, such as cysts or masses. Open surgery has been considered the definitive form of treatment. Although these procedures have produced excellent results, they can be associated with significant morbidity, such as rectal and bladder wall injury, ureteral injury, injury to the erectile neurovascular bundle and pelvic urinoma. With the growing experience in laparoscopics, this approach is becoming the preferable way to access the seminal vesicles. Our objective is to demonstrate a step-by-step operative technique for laparoscopic unilateral vesiculectomy approach in a man with hemospermia_x000D_


A 61 year-old man presented with 1 year of hemospermia. He was treated empirically with a fluoroquinolone plus a nonsteroidal anti-inflammatory without resolution of symptoms. Ultrasonography and MRI showed a solid-cystic mass in the right seminal vesicle. The patient was submitted to a laparoscopic unilateral vesiculectomy. Histopathological analysis showed intraluminal dilatation with blood content. During follow-up, complete resolution of symptoms was seen


Three patients composed our cohort. Mean age was 53 years-old (range 45 - 61y), the right side was more commonly affected (two unilateral on the right and bilateral). Mean operative time was 55 minutes (range 40 - 120min). One patient presented amyloidosis in the histopathological analysis. All cases presented complete resolution of symptoms


Laparoscopic vesiculectomy is a safe and feasible approach in cases of hemospermia. This technique showed good outcomes and minimal morbidity

Funding: none