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Question: For about 2 years, on and off, I have felt a strange discomfort in my penis

[Kevin Pho, MD]

Even though the prostate exam was negative, this is still highly suspicious.  Blood in the semen, urinary hesitancy, testicular pain, a sensation on the back of your thighs all suggest a prostate disorder.  

You are correct in saying that in most cases hematospermia often goes away on its own.  However, any type of prostate disorder often causes this (i.e. infection).  If the prostate exam was negative, I would suggest further imaging to evaluate the prostate.  A transrectal ultrasound can identify structural abnormalities of the prostate gland, seminal vesicles, and spermatic cord, and guide biopsies if any suspicious abnormalities are identified in those organs.

In addition, I would also suggest a scrotal ultrasound to evaluate the pain in the testicles.  Tests for STDs such as gonorrhea or chlamydia should also be obtained if not already.  

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.

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