27 yr old w/high psa level urinating blood after having sex or just an erection

[losst]

i am 27 yrs old.in august i had sex 3 times in one evening and blood came out in my semen the third time.i then urinated blood and a clot came out at the end. i consulted a urologist and we found that my psa level was very high for my age and normal for a 50 yr old.a transrectal ultrasound followed by a prostate biopsy showed no sign whatsoever of any type of inflammation or anomaly.2-3 weeks after the biopsy and all of the blood caused by it were out of my system, i noticed that no blood was coming out during masturbation.i had sex and everything was back to normal.this was in october.until july i was having sex 3-4 times per week, with no problem whatsoever.in mid-may the problem was back.i was extremely erect and after ejaculating inside my partner, i saw a bit of blood in the condom.i urinated a lot of blood and the the clot came out.before having the biopsy,i did not bleed every single time i ejaculated.since may things have changed.blood comes out with the semen, followed by blood in the urine and a clot at the end, after having sex, but not after masturbating.i guess this has to do with the fact that a woman gets you much more excited than your hand,and also the fact that you are more active during sex.what i don't understand is why the bleeding stopped a few weeks after the biopsy,why the dr told me that it was just some infection,why my psa level is still the same (i tested it 3 months ago),and why i have this probelm again, the difference being that i do not bleed when i masturbate (although i did when the problem began).i have no problem with getting an erection and i am healthy and feel good despite the fact that this story has been the worst part of my life so far.the dr told me that i am a rare case, and that i would have to make a lot of tests without having sex for at least 3 days.it will take 10 days for the results to come out.he told me that once we get the results, he will do some testing immediately after i have sex to see the differences.what is even more disturbing is that i urinated blood on 2 separate occasions without having sex or masturbating.both times occurred after having a lap dance at a strip club.i had an erection during both times and both blod and the clot came out not only the first urination, but after the second time i urinated.the last time this happened was very painful indeed.i urinated blood and a clot came out.it hurt a lot.i suspected that it more blood would appear and i urinated in my sink.i was right.blood came out again but this time it took the clot 2-3 minutes to travel down the urethra and come out.i could actually feel it getting stuck and struggling to go down.i was close to fainting during those few minutes.i kept the clot (or whatever it is), because it hurt me a lot.it is round/oval shaped and flat,and its diameter is more than twice the size of the diameter of a 2euro coin.i had to wait for 3 days to do the semen,urine+blood analyses.i masturbated to get a sample and my urethra is itching.

[Kevin Pho, MD]

Infection can be considered, and evaluated with a urine sample and urethral swabs for STDs.  

I agree with a transrectal ultrasound and prostate biopsy.  This can be repeated if the symptoms continue.

Another consideration would be a cystoscopy to comprehensively image the lower GU tract.  This can evaluate for a source of bleeding from the bladder, which may lead to your symptoms.

These options can be discussed with your personal physician or urologist.

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.

Kevin, M.D.
kevinmd_

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