Objective      To determine feasibility and safety of transprostatic utricle Holmium laser incision of ejaculatory duct in the treatment of refractory hemospermia.       Methods      Totally 23 patients with hemospermia (mean age of 47.3±6.5

ranging from 38 to 61 years) for 5.8±1.7 months (ranging from 3.5 to 27 months) admitted in our department from 2010 to 2014 were enrolled in this study. All patients had received conservative therapy for 3.4 months (ranging from 3.0 to 5.6 months)

and their main manifestations were repeated hemospermia. Painful ejaculation was observed in 12 patients

and perineal and testicular pain in 4 patients. They all underwent transprostatic utricle incision of ejaculatory duct by Holmium laser

and then followed up for 3 to 6 months.       Results      All 23 patients were operated successfully

with operation time of 28.0±4.2 min (ranging from 20 to 42 min) and hospital stay of 1.5 d (from 1 to 3 d). The operation revealed that the causes of hemospermia were seminal vesiculitis in 14 cases

accompanied with seminal calculi in 6 cases

and with seminal vesicle polyps in 1 case

and 2 cases of agnogenic hemospermia.No incontinence

rectal injury

or other surgical complications was found during follow-up. Hemospermia disappeared in 19 patients within 1 month after surgery

in 3 patients within 1 to 2 months and in 1 patient within 2 to 3 months. No hemospermia recurrence was observed in all the patients in the period of follow-up.       Conclusion       Transprostatic utricle Holmium laser incision of ejaulcatory duct is a safe

easy and effective to operate in the treatment of refractory hemospermia.