Blood in semen and urine

[Susan1022]

My boyfriend (healthy 56 year old male with no ED) developed hematospermia a few months ago. It happens upon ejaculation, and afterwards he may see a small blood clot in his urine.  It goes away, and then randomly returns. His PCP told him to abstain from sex for a few weeks as it is probably a damaged blood vessel and it would heal on its own.  We did that, but it seems to return randomly.  He has no genital sores or outbreaks of any kind.  One concern is that he was bicycling a lot last summer and had a problem with numbness in the groin.  The hematospermia began a month or two later and has appeared on and off ever since.  My other concern is that a lesion about an inch long and 1/4" wide on his abdomen near his navel appeared twice in the last few months. I am not sure if it has coincided with the incidence of hematospermia. Right now it has healed again but there is a dark pink scar.  He does take meds for blood pressure and cholesterol.  Can you shed any light on this?  Might this be indicative of a sexually transmitted disease, or prostate cancer? Thank you..

[Stephen Liroff, MD]

Your boyfriend's hematospermia is certainly an upsetting occurrence but is usually of little significance. It is usually a self limiting problem (goes away by itself)  without an obvious cause. Workup consists of a good history and physical exam with possibly a semen culture and PSA (prostate specific antigen). If it fails to resolve (assuming that nothing turned up on his physical exam), then transrectal ultrasound or MRI can be performed as well as cystoscopy (looking into his urethra/bladder with a small telescope), recognizing that the chance of finding a cause is still quite slim. Abstinence is not usually prescribed. The textbooks do mention cancers of the prostate, seminal vesicles and urethra as possibilities but these are, again, quite rare.
I do not understand the abdominal lesion which you describe and certainly do not see it as related to the blood in his ejaculate unless he has a clotting problem and he is experiencing bruising in his lower abdomen.
The groin discomfort I do not see as related.
I think that he should see a urologist to get an expert opinion.
Good luck!
S.A.Liroff, M.D.
"This information is provided for general medical educational purposes only. It
does not  necessarily reflect the opinions of Henry Ford  Hospital  or the
Vattikuti Urologic Institute.  Please consult your physician for diagnostic
and treatment options pertaining to your specific medical  condition.”

[the los]

You might want to check out this forum. It specifically deals with Blood in the Semen/ Urine. It is more common than you think, but it still throws a few Urologists for a loop.
The forum is at:
http://home.comcast.net/~carlojd/site/