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Re: blood in semen

Posted By HFHS M.D.-AK on February 13, 1999 at 14:30:22:

In Reply to: blood in semen posted by Brian on January 31, 1999 at 22:46:26:

After intercourse, I noticed small amounts of blood in my semen.  It appears that some came out during pre-ejaculation and possibly during the beginning of ejaculation.  I am 27 years old, healthy, monogamous and am experiencing no other symptoms that are obvious.  I don't know if this is an unusual condition or any conditions it could be related to.  Any thoughts?  My wife and I are concerned.

Dear Brian,
Hematospermia is a disconcerting symptom that produces extreme anxiety in sexually active males.  Hematospermia refers to the presence of blood in the seminal fluid.  The etiology is not specifically known and is poorly understood.  Most commonly, it results from nonspecific inflammation of the urethra, prostate, and/or seminal vesicles.  Hematospermia also occurs frequently after a needle biopsy of the prostate, but you have not had this procedure done.  Most men with hematospermia are in their 30s and it almost always resolves spontaneously, usually within several weeks.  Hematospermia may be associated with infection, but is rarely secondary to malignancy.  Patients that have persistent hematospermia more than three weeks should undergo further urologic evaluation to identify a specific cause.  The physical exam should include a genital rectal exam, PSA, urine cytology and a blood pressure. Hypertension can be associated with hematospermia.  Some urologists recommend transrectal ultrasound to look for stones and cysts in the prostate, seminal vesicles and ejaculatory ducts. This may also help rule out prostate cancer.
Other urologists recommend cystoscopy because hematospermia can be secondary to urethral and prostatic pathology.
Overall, hematospermia almost always resolves spontaneously and rarely is associated with significant urinary pathology.  In a Japanese study, less than 1% of patients had prostate cancer associated with hematospermia.  Unless a specific etiology is found, most cases are managed expectantly.
This information is provided for general medical educational purposes only.  Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.  More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
*keyword: Hematospermia

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