A conventional procedure for treating hematospermia is to insert a ureteroscope or seminal vesiculoscope into the prostatic utricle through the urethra, and then dilate the ejaculatory duct opening using the scope or the catheter. However, the ejaculatory duct stenosis may occur after the simple ureteroscopy. We compared the outcomes of treating hematospermia using holmium laser incision through a ureteroscope and using simple ureteroscopy. Retrospective method was used to analyze 67 intractable hematospermia cases. Varying degrees of ejaculatory duct stenosis or obstruction were observed in all the patients. Postoperative follow-up was conducted for 6 months up to 3 years. Two patients who underwent the simple ureteroscopy experienced hematospermia recurrence in 6 and 8 months, respectively. No recurrence was found in all the patients who underwent the holmium laser incision. We have found that the holmium laser incision through a ureteroscope shows a better outcome than the simple ureteroscopy.

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