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Urology  (Expert Forum)
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high psa level and blood in semen
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
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.

high psa level and blood in semen

by moupa, Aug 18, 2005 12:00AM
i am 26 years old, heterosexual, and healthy. 5 weeks ago i experienced pain while having sex with my girlfriend, who was on top of me. it felt as if my penis had moved too much. i ejaculated and everything was normal. we had sex again and the ejaculation was normal. the third time we had sex that same day, i felt exhausted prior to ejaculating, so i stopped. i went to the toilet to urinate and blood came out along with urine. at the very end came out a piece of blood clot. it was quite large. the following day a doctor came to see me. he tested if there was blood in my urine and said that there wasn't and that everything was ok. he told me that perhaps my penis had moved to a position that it had never been in before, due to hard sexual intercourse, and that bleeding was a normal thing. i did not have sex or masturbate for 3 days. i then had sex twice and no blood came out. my next sexual encounter occurred 4 days later. blood came out with the semen. i urinated a few minutes later and blood with urine came out once again, followed by a piece of blood clot. during all of this time, i was traveling with my girlfriend. having been told not to worry by the doctor who had visited me, i waited and saw a doctor in my city 3 days after the last time i had sex. the doctor i saw is a urologist specialized in prostate cancer. he told me that the only thing that worried him was the fact that pieces of blood clot were coming out sometimes. he told me not to worry and that he was 99 per cent sure that nothing was wrong. he then said to make a blood, urine, and semen test, and to see him 2 weeks later, because he would be out of the country. i got the results a few days later. everything was normal except for a high level of PSA. the doctor came back today and i visited him in the morning. he told me that my PSA level was high and that this amount is found in 50 year old men. this and the blood clot worried him. he then checked the size of my prostate with his finger through my rectum and said that it was normal. he told me to go to a radiologist to make tests so that he could have a clear view of the situation. i asked him what could be the cause of my problem and he said that perhaps it was an infection, or maybe a cyst, without specific. when i mentioned cancer he said nothing and said to wait until we get the results. i will be tested on the 23rd of august and the results should come out by the 29th of august. i am living alone and abroad and haven't told my family about this. i will wait until i know exactly what is going on. what i have read about prostate cancer has scared me, and the doctor's attitude of not rushing scares me even more. i am moving to another country 2 days after i get the results and this complicates things. what causes PSA to rise (i am only 26)?
what causes prostate cancer? can you recommend a doctor in spain (i live in barcelona) so that i can get a second opinion?
thank you

by Kevin Pho, MD, Aug 19, 2005 12:00AM
Possible causes of blood in the semen can include infection, or a prostate disease (infection or cancer).  At age 26, cancer would be less likely.  There are some cases of blood in the semen that cannot be found.  

A transrectal ultrasound is the most reasonable test to further evaluate the symptoms.  This can image the prostate and evaluate for any cysts or cancer.

PSA can rise in the setting of infection, trauma (i.e. during physical sex or even a digital rectal exam), or cancer.  The ultrasound would give a more definitive answer.

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.
http://www.straightfromthedoc.com
Member Comments (3)

by S1eezy, Aug 19, 2005 12:00AM
To: Urology - General
0

by moupa, Aug 19, 2005 12:00AM
To: Urology - General
0

by moupa, Aug 22, 2005 12:00AM
To: Urology - General
0
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