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Urology  (Expert Forum)
 | 
blood in ejaculate
Answered by
Kevin Pho, MD - Internal Medicine
Kevin, M.D. Boston - MA
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.

blood in ejaculate

by remlap, Apr 14, 2004 12:00AM
60 yr. old healthy male, recent psa 2.2, benigh nodule on somewhat enlarged prostrate (urologist exam. 3/30/04), ultrasound biopsy scheduled 5/04.  over past 3 to 4 weeks have increased sexual frequency to 1 to 2 X's day with 100mg Viagra and one time trial of Cialis, supplemented by 50mg of viagra per 2 days (approx 10 days ago)



yesterday experienced non-painful, bright red blood discharge with exaculation...subsequent, non-painful urination exhibited decreasing pink urine, resulting in visually clear after 3 urinations...



questions:



1. what is likely diagnosis?

2. what is likely causation?

3. is this a likely side effect of Viagra or Cialis?

4. is an immediate contat with urologist recommended?



by Kevin Pho, MD, Apr 14, 2004 12:00AM
To answer your questions:

1) There are a variety of causes for hematospremia (blood in the ejaculate).  They include benign and malignant disorders of the prostate gland, seminal vesicles, spermatic cord, and ejaculatory duct system; urogenital infections; metastatic cancers; and vascular disorders. However, it is often impossible to know with certainty whether these conditions are the cause of hematospermia. The cause is idiopathic (i.e. without a clear cause) in a substantial proportion of patients, and the condition frequently resolves spontaneously.



2) see above



3) It is unlikely a side effect of those medications.



4) I would discuss this with your urologist.  Normal next step would be a transrectal ultrasound to evaluate the prostate - in your case, you are already having a biopsy.  You may want to consider moving up the procedure date.

Followup with your personal physician is essential.



This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.



Thanks,

Kevin, M.D.



Bibliography:

Weiss et al.  Hematospermia.  UptoDate, 2004.
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