hard lump and blood in semen

I am a 20 yr old male in relativly good health.  I have had a hard lump/bb thing on my left testicle for at least a year now. I never thought it to be anything until reading about testicular cancer. I have also had blood in my semen.  The blood has been in my semen on and off for 2 years. I have heard it to be common and thought nothing of it. I have also noticed that if I ejaculate daily I almost never get blood in my semen, but if I hold off a week or two there is almost always blood in it. I also am experiencing blood with my bowel movements,while wiping afterwards, although I am certain that is a Hemorrhoid. I am not experiencing any pain or anything of that nature. Whats wrong with me?

-Anon

[Kevin Pho, MD]

Blood in the semen (known as hematospermia) can be caused by a variety of diseases.  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.  Most of the time, especially in the younger population, a clear cause cannot be found and it resolves on its own.  A visit to a urologist would be helpful to for further evaluation.  

Regarding the lump in the testicle, an ultrasound should be considered to rule out a mass, cyst or varicocele.

Regarding the blood in the stool - it is most likely a hemorrhoid (given your young age).  A visit to a physician for a possible anoscopy (a small scope to make sure it is nothing worse than a hemorrhoid) should be considered.

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.

[kevinmd]

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