Vancouver, British Columbia—A study of 143 men with hematospermia revealed that approximately 15% also had hyperuricemia.
Clinician-researchers at Assiut University Hospital, Egypt, undertook the case review because they noticed that a lot of patients with hematospermia also had elevated plasma uric acid level, or hyperuricemia (>7 mg/dL). They felt that hyperuricemia may have been overlooked in previous studies of hematospermia. The team, led by Adel Kurkar, MD, Urologist, analyzed information from each of the 143 cases of hematospermia that presented to the hospital’s outpatient clinic between July 2005 and July 2012.
The information gathered at the time of presentation included urinalysis, urine and semen cultures for specific and nonspecific infections, bleeding profile, liver function tests, serum uric acid, prostate-specific antigen, abdominal ultrasound, plain x-ray of the urinary tract, semen analysis, examination and culture for expressed prostatic secretion, transrectal ultrasound with or without biopsy, computed tomography scan, magnetic resonance imaging, and urethrocystoscopy.
The most common concomitant disorders included schistosomiasis (21.6%), hyperuricemia (15.38%), idiopathic (14.7%), chronic prostatitis (8.4%), and tuberculosis (8.4%).
At presentation, the mean age of patients with hyperuricemia was 32 years. They reported episodes of hematospermia for 2 to 8 months before they came to the hospital; average serum uric acid level was 9.2 mg/dL (range, 7.6-11.4 mg/dL). Furthermore, 15 patients had painful ejaculation, 14 had lower-urinary-tract symptoms, 12 had arthralgia, 10 had urate crystals in the urine, 7 had urate crystals in the semen, and 5 had dotted prostate calcifications on transrectal ultrasound.
The physicians prescribed allopurinol 300-mg tablets twice daily for 8 weeks, followed by 300 mg daily. They analyzed the patients’ semen once monthly until the symptoms resolved, which took between 1 and 4 months, and they continued to analyze the semen at 3-month intervals for another year to check for recurrences.
Coinvestigator Ahmad A. Elderwy, MD, Urologist, Assiut University Hospital, and Visiting Pediatric Urology Fellow, Seattle Children’s Hospital, WA, told Value-Based Care in Rheumatology, after he and his colleagues presented the information at the 2013 Société Internationale d’Urologie annual meeting, that they recommend an assessment of serum uric acid levels in men presenting with hematospermia, especially those with gout symptoms. In addition, the patients should be referred to a rheumatologist, Dr Elderwy said.