2008 Annual Meeting Abstracts
Dutasteride In The Treatment Of Hematospermia Refractory To Antibiotic Therapy
Yury Bak*, Sean A Castellucci, Phillip C Ginsberg, Michael J Metro, Richard C Harkaway
Albert Einstein Medical Center, Philadelphia, PA
Introduction. Hematospermia is often a benign but bothersome finding in men of all age groups. Antibiotic therapy has been the standard first-line treatment given its association with infectious etiologies. No other standard of care for refractory hematospermia has been designed. Our study evaluated the effectiveness of dutasteride, a dual 5-alpha-reductase inhibitor, to treat hematospermia refractory to antibiotic therapy.
Methods. 65 men between the ages of 40 and 72 presented over a two year period with hematospermia of 1 to 26 weeks duration. Eleven of them were found to have elevated PSAs and were excluded from the study. The remaining 54 patients were given a 6-week course of flouroquinolone antibiotics. Patients who complained of persistent hematospermia were further evaluated with transrectal ultrasonography and given a 3-month trial of dutasteride 0.5mg.
Results. 30 of the original 54 patients had complete resolution of their hematospermia with antibiotics alone. Of the 22 patients with persistent hematospermia and nonmalignant lesions on ultrasound, 16/22 men (66.7%) had resolution of their hematospermia on dutasteride therapy.
Conclusions. Initial treatment of hematospermia frequently and appropriately includes fluoroquinolone therapy. If the antibiotic therapy fails to resolve the hematospermia, and further workup does not reveal a definitive and treatable cause, dutasteride seems to be a reasonable second-line treatment independent of patient age or PSA.