Journal Information
Vol. 30. Issue. 2.March 2010
Pages 143-269
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Haemospermia in malignant hypertension
Hemospermia en la hipertensión maligna
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Luis Quiñones Ortiza, A.. Suárez Laurésa, A.. Pobes Martíneza, A.. Torres Lacallea
a Servicio de Nefrología, Hospital Cabueñes, Gijón, España,
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Dear Editor, Specialised literature informs us that hypertension may accompany haemospermia. This association may be considered merely statistical, but the fact that it appears in more severe hypertension, such as malignant hypertension, cannot.We present the case of a 36-year old man who visited the hospital due to emitting blood in the semen. Apart from the presence of untreated hypertension which had been present for ten years, there were no other relevant data. Examination, laboratory testing, cultures and imaging techniques did not provide any data regarding its origin. Furthermore, the urological history was uneventful, with no history of trauma or infection, and there were no accompanying clinical profiles, prior medications or sexual habits that could be considered abnormal. The patient had a blood pressure of 220/140mmHg, and was asymptomatic with the following relevant data: ocular fundus with oedema of the optic nerve, exudates and haemorrhages, ECG in which we observed ventricular hypertrophy with a systolic overload, renal failure (Cr > 3mg/dl) with proteinuria ++++. In a previous analysis, renal function had been normal. The usual hormonal and radiology studies to rule out secondary hypertension were negative. He was identified as a malignant hypertension patient, and it was believed that a kidney biopsy would not be indicated or appropriate. Haemospermia is generally a selflimited, benign process which is idiopathic in many cases. In others, it is secondary to aggressive urological examination, exacerbated sexual activity or excessive sexual continence, or rarely, a tumour. Underlying hypertension is described in at least 6% of all cases.2 Coinciding haemospermia and malignant hypertension has occasionally been described by several authors.3,4 An association between asymmetrical ectasia of the seminal vesicle (seminal ectasia can cause haemospermia) and severe hypertension can also be described.Although the physiopathology of the process behind this association is not clear, presence of haemospermia in these acute forms of high blood pressure, which has already been described, may not be a mere coincidence.     

Bibliography
[1]
Close CF, Yeo WW, Ramsay LE. The association between hemospermia and severe hypertension. Postgrad Med J 1991;67:157-8. [Pubmed]
[2]
Ahmad I, Krishna NS. Hemospermia. J Urol 2007;177:1613-8. [Pubmed]
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Fleming JD, McSorley A, Bates KM. Blood, semen and innocent man. Lancet 2008;371:958. [Pubmed]
[4]
Bhaduri S, Riley V. Hematospermia associate with malignant hypertension. Sex Transm Inf 1999;75:200.
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Weidner W, Jantos CH, Schumacher F, et al. Recurrent hemospermia-underlying urogenital anomalies and efficacy of imaging procedures. Br J Urol 1991; 67:317-23. [Pubmed]
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Nefrología (English Edition)

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