Blood in semen (haematospermia)

What is haematospermia?

Haematospermia, or blood in the semen, is a condition where blood is present in the ejaculate. While it can be alarming, it is often benign and self-limiting. However, it can sometimes indicate underlying medical conditions that require attention.

Causes of haematospermia

Haematospermia can result from various causes, including:

  • Infections: Prostatitis, urethritis, or sexually transmitted infections (STIs) can cause inflammation and bleeding.
  • Trauma: Injury to the genital area or recent procedures such as a prostate biopsy.
  • Medical conditions: Benign prostatic hyperplasia (BPH), cysts, or stones in the seminal vesicles (small glands near the base of the bladder), or prostate.
  • Systemic diseases: Hypertension, bleeding disorders, or chronic liver disease.
  • Cancer: In rare cases, prostate, testicular, or bladder cancer can cause haematospermia.

Symptoms to watch for

In addition to blood in the semen (which may range from pinkish to dark red in colour), you may experience:

  • Painful ejaculation.
  • Blood in urine (haematuria).
  • Pain or swelling in the scrotum.
  • Lower abdominal or pelvic pain.
  • Fever or chills (if infection is present).

 

When to seek medical advice

While haematospermia is often benign, you should seek medical advice if:

  • The condition persists for more than a few weeks.
  • You experience significant pain or discomfort.
  • There is a history of urinary tract infections or other urological issues.
  • You have other symptoms such as weight loss, fever, or difficulty urinating.

How will I be assessed?

During your consultation, your urologist will:

  • Review your medical history: Discuss any previous health issues, medications, and recent procedures.
  • Conduct a physical examination: Examine the genital area, prostate, and abdomen.
  • Diagnostic tests may include:
    • Urinalysis: To check for infection or blood in the urine.
    • Semen analysis: To identify the presence and extent of blood in the semen.
    • Blood tests: To assess for signs of infection, inflammation, or other systemic conditions.
    • Imaging studies: Ultrasound or MRI to visualise the prostate, seminal vesicles, and surrounding structures.
    • Cystoscopy: A procedure that allows the urologist to look inside the bladder and urethra.

 

Treatment options 

Treatment for haematospermia depends on the underlying cause:

  • Monitoring: In cases where no serious cause is identified, haematuria often resolves without treatment. Monitoring and reassurance may be sufficient.
  • Infections: Antibiotics to treat bacterial infections.
  • Inflammation: Anti-inflammatory medications in cases of inflammation or irritation. 
  • Procedures: Surgical intervention for underlying conditions such as cysts, stones, uretral strictures or varicoceles.

Potential risks and complications

While haematospermia itself is often benign, complications can arise if an underlying condition is not addressed:

  • Chronic infection or inflammation.
  • Progressive urological disease.
  • Unidentified malignancy.

Risks associated with treatment

Generally minimal but can include: 

  • Side effects from medications: Allergic reactions or gastrointestinal disturbances. 
  • Surgical complications: Infection or bleeding. 

Recovery

Recovery from haematospermia depends on the underlying cause and the chosen treatment. For most cases, recovery involves: 

  • Monitoring symptoms for improvement. 
  • Following prescribed medications or post-surgical care instructions. 
  • Regular follow-up visits with healthcare providers to ensure resolution and monitor for recurrence.

Post-treatment care

  • Follow-up appointments: Regular check-ups to monitor your condition and response to treatment.
  • Lifestyle adjustments: Maintain good hygiene and safe sexual practices.
  • Hydration and diet: Stay hydrated and follow a healthy diet to support overall urological health.

Benefits of timely diagnosis and treatment

  • Peace of mind: Understanding the cause of haematospermia can alleviate anxiety.
  • Effective management: Targeted treatment can address underlying conditions and prevent complications.
  • Improved health: Early intervention can improve overall urological health and quality of life.

While haematospermia can be distressing, it is often benign and resolves without intervention. Treatment, if necessary, focuses on addressing underlying causes identified through comprehensive evaluation and may include observation, medications, or surgical intervention as appropriate. 

Why choose Birmingham Urology Centre

At Birmingham Urology Centre, our experienced urologists provide comprehensive evaluation and treatment for haematospermia.  We use the latest diagnostic tools and techniques to ensure accurate diagnosis and effective treatment plans tailored to your needs.

Contact us today to book an appointment or for more information on haematospermia and treatment options

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