P-02-44 Implications of Multiparametric Prostate MRI in Patients With Hematospermia

Abstract

Hematospermia is a benign condition that is rarely associated with significant disease and the need to exclude malignanancy is controversial. In this context we aimed to evaluate multiparametric prostate MRI (MP-MRI) findings in patients with hematospermia. In this prospectively managed retrospective study, twenty-three patients with hematospermia received 3T MP-MRI between October 2017 and September 2019. We also studied prostate-spesific antigen (PSA), mycobacterium tuberculosis DNA-polymerase chain reaction (TB-PCR) in the urine and urine analysis/culture. Median age was 49 (Range 30-73). No patient had gross hematuria episodes or a family history of prostate cancer or was using anticoagulants. Past medical history revealed chronic prostatitis (2) and epididimitis (2) in a total of 4 patients. All patients had normal digital rectal examination. Median PSA was 0.88 ng/ml (Range 0.6-5.4). TB-PCR and urine analysis/culture test were negative for all patients. Four (17%) patients had utricular cyst on MP-MRI imaging. MP-MRI revealed PI-RADS 1, PI-RADS 2, PI-RADS 3 and PI-RADS 4 lesions in 3 (13%), 13 (57%), 3 (13%) and 4 (17%) patients, respectively. All PI-RADS 2 and PI-RADS 3 lesions were commented as either focal chronic prostatitis or fibrosis by uroradiologist. Three patients with PI-RADS 3 lesions and low PSA values (< 1 ng/ml) were recommended PSA follow-up only. Patients with PI-RADS 4 (Mean PSA: 3.65 ng/ml (range: 1.58-5.39)) underwent cognitive MRI-guided biopsy. One patient (PSA 2.7 ng/ml) was diagnosed with a Gleason 3+4 prostate cancer.