Dear Editor,rnThe patient was a 29-year-old male seeking medical treatment for a 2-year history of primary infertility,and no reproductive abnormalities were observed in his 29-year-old spouse.The study protocol was approved by the Ethics Committee of the First Affiliated Hospital of Dalian Medical University(Dalian,China),and the informed consent was provided by the patient for the publication of his clinical data.The patient denied a history of urinary tract infection and epididymitis,but reported a history of hematospermia.Palpation revealed no palpable varicoceles,normal-sized epididymides,palpable vasa deferentia,and the bilateral testes of 20 ml in volume.Test results revealed no abnormalities in the levels of sex hormones(Supplementary Table 1).Semen analysis showed severe asthenozoospermia(Supplementary Table 2).Seminal plasma biochemistry analysis showed fructose level of 1.8 mmol1-1(normal level ＞8.3 mmol l-1).Magnetic resonance imaging(MRI)and transrectal ultrasound scan(TRUS)indicated hemorrhage in the right seminal vesicle and bilateral seminal vesicle dilation(Supplementary Figure 1).During TRUS,the patient masturbated until ejaculation,while retaining an transrectal ultrasound probe(Esaote S.p.A.,Genoa,Italy)in his rectum,which tracked the process of ejaculation in real time(Supplementary Video 1).Calcification blockage within the ejaculatory ducts and verumontanum was observed(Figure 1).