Robotic unilateral seminal vesiculectomy for chronic hematospermia

Hematospermia is typically self-limited and warrants no surgical intervention. However, chronic hematospermia requires investigation and treatment depending on etiology. We present an unusual case of chronic hematospermia for 5 years in a 22-year-old patient, which failed conservative medical management. MRI was conducted which revealed left seminal vesicle (SV) distended with blood and a normal right SV. He was treated with robotic unilateral seminal vesiculectomy (RUSV). At 6 months follow-up, ejaculation was normal and hematospermia resolved. Therefore, RUSV is a valid option for chronic hematospermia and can preserve normal ejaculatory function, particularly if the SV responsible for the hematospermia is lateralized.