MP35-04 HAEMOSPERMIA IN THE REAL-LIFE SETTING: CHALLENGING THE EAU GUIDELINES

Abstract

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Prostate & Genitalia (MP35)1 Sep 2021MP35-04 HAEMOSPERMIA IN THE REAL-LIFE SETTING: CHALLENGING THE EAU GUIDELINES Edoardo Pozzi, Eugenio Ventimiglia, Giuseppe Fallara, Luca Boeri, Federico Belladelli, Daniele Cignoli, Luigi Candela, Paolo Capogrosso, Nicolò Schifano, Massimiliano Raffo, Gianmarco Colandrea, Julian Cornelius, Agostino Mattei, Costantino Abbate, Francesco Montorsi, and Andrea Salonia Edoardo PozziEdoardo Pozzi More articles by this author , Eugenio VentimigliaEugenio Ventimiglia More articles by this author , Giuseppe FallaraGiuseppe Fallara More articles by this author , Luca BoeriLuca Boeri More articles by this author , Federico BelladelliFederico Belladelli More articles by this author , Daniele CignoliDaniele Cignoli More articles by this author , Luigi CandelaLuigi Candela More articles by this author , Paolo CapogrossoPaolo Capogrosso More articles by this author , Nicolò SchifanoNicolò Schifano More articles by this author , Massimiliano RaffoMassimiliano Raffo More articles by this author , Gianmarco ColandreaGianmarco Colandrea More articles by this author , Julian CorneliusJulian Cornelius More articles by this author , Agostino MatteiAgostino Mattei More articles by this author , Costantino AbbateCostantino Abbate More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , and Andrea SaloniaAndrea Salonia More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002044.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: EAU guidelines suggest stratifying patients presenting with haemospermia into low risk vs. high-risk categories. We compared the clinical characteristics of a cohort of men presenting with haemospermia categorised as low vs. high risk and we investigated whether being high risk was associated with severe disease outcomes (SDO) and/or positive semen cultures at first evaluation. METHODS: 283 patients complaining of a single episode/recurrent haemospermia were analysed. Patients were stratified into low vs. high risk according to EAU guidelines. Baseline data were collected for every patient. Health significant comorbidities were scored with the Charlson Comorbidity Index (CCI). Descriptive statistics compared the overall characteristics between the two groups. Logistic regression analysis tested whether being high-risk was a predictor of SDO (prostate (PCa) OR bladder cancer (BC)) and/or of positive semen cultures. ROC curves tested the accuracy of the logistic regression models in predicting SDO and positive semen culture. RESULTS: Of 283 patients, 258 (91.16%) were identified as high risk and 24 (8.48%) as low risk patients. Median (IQR) age and BMI of the whole cohort were 49 (37-60) years and 25.06 (23.07-27.26) kg/m2, respectively. Of all, 31 (11%) reported positive semen cultures, at first presentation, with 10 (3.5%) sexually transmitted infections and 21 (7.4%) extracellular pathogens. A diagnosis of PCa or BC were observed only in the high-risk group 12 (4.2%) and 1 (0.4%) respectively. High risk patients were older (51 (40-61) vs. 27 (26-29) years, p<0.0001) and were more likely to report CCI≥1 (121 (47.1%) vs. 5 (20.8%). At multivariable logistic regression analysis, recurrent haemospermia (OR: 2.92, p=0.02), history of STD (OR: 2.28, p=0.0009) and history of rUTI (OR: 1.09, p=0.02) were identified as independent predictors of positive semen cultures after adjusting for being classified as high-risk, CCI≥1 and LUTS/BPH. Likewise, being high-risk was not identified as an independentpredictor for SDO (p=0.99) after adjusting for CCI≥1, BMI, PSA ≥2 ng/mL and recurrent haemospermia. ROC curves revealed that both models have good predictive ability (AUC: 0.74, 95%CI: 0.64-0.84) and (AUC: 0.71, 95%CI: 0.56-0.86). CONCLUSIONS: Nine out of ten patients were high risk according to EAU guidelines. Being high-risk was not identified as a predictor of SDO and of positive semen cultures at first evaluation. On the contrary, recurrent haemospermia, history of STD and history of rUTI were identified as independent predictors of reporting positive semen cultures in the real-life settings. Source of Funding: none. © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e627-e628 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Edoardo Pozzi More articles by this author Eugenio Ventimiglia More articles by this author Giuseppe Fallara More articles by this author Luca Boeri More articles by this author Federico Belladelli More articles by this author Daniele Cignoli More articles by this author Luigi Candela More articles by this author Paolo Capogrosso More articles by this author Nicolò Schifano More articles by this author Massimiliano Raffo More articles by this author Gianmarco Colandrea More articles by this author Julian Cornelius More articles by this author Agostino Mattei More articles by this author Costantino Abbate More articles by this author Francesco Montorsi More articles by this author Andrea Salonia More articles by this author Expand All Advertisement Loading ...