The following is a summary of “Haemospermia in the Real-Life Setting: A New High-Risk Stratification,” published in the JANUARY 2023 issue of Urology by Pozzi, et al.

For a study, researchers sought to identify a novel risk stratification for patients complaining of hemospermia and compare its predictive ability to choose high-risk patients by retrospectively validating the EAU guidelines classification.

A retrospective analysis was performed on data from 283 patients who complained of recurrent or isolated episodes of hemospermia. According to EAU recommendations, patients were categorized as low- or high-risk, and the diagnostic accuracy was then verified. On the basis of clinical factors connected to positive semen culture and prostate cancer (PCa) and bladder cancer (BC), we discovered a new risk stratification model. Decision curve analyses (DCA) were used to test the clinical utility of the two predictive models (EAU vs. New), which were evaluated for their diagnostic accuracy.

According to the EAU recommendations, 24 (8.5%) of the 259 patients had low risk, and 259 (91.5%) had high risk. About 134 patients (47.4%) reported having recurrent hemospermia. A baseline CCI score of ≥1 or lower was present in 126 individuals (44.5%). A positive semen culture was predicted by a history of recurrent genito-urinary tract infections using MVA logistic regression analysis (OR: 3.39, 95% CI: 1.77 – 6.57, P =.002). The same study found that baseline CCI≥ 1 predicted PCa and BC (OR: 1.55, 95% CI: 1.17 – 2.04, P =.009). The new model performed significantly better: 98.9%, 58%, and 78%, respectively. The sensitivity, specificity, and AUC of the EAU standards were 13.3%, 89.2%, and 51%, respectively.

The risk classification method used by the EAU did not guarantee the accurate identification of high-risk individuals who are complaining of hemospermia. Therefore, they suggested a brand-new risk classification method that performed better and was simple.

Reference: goldjournal.net/article/S0090-4295(22)00831-7/fulltext