Blood in the semen (haematospermia)
What is haematospermia?
The presence of blood in the semen is called haematospermia. Haematospermia usually presents as painless blood staining of the semen, noticed on ejaculation. The patient usually presents with brownish to red discoloration of ejaculate. It is usually a painless, benign, isolated and self-limiting symptom.
In more than 50% of patients, the cause of haematospermia is not clearly understood or known.
The most common causes of haematospermia are: urinary tract or sexually transmitted infections, malignancies and trauma, prostate cancer, following prostate biopsy or it may be a complication associated with a transurethral prostate resection.
Investigation
Urological evaluation include urine or semen analysis to exclude urinary tract infection, digital PR examination of the prostate, PSA blood test and in persistent and recurrent cases of haematospermia transrectal ultrasound examination, cystoscopy and CT or MRI scanning
The majority of the patients with haematospermia who have been studied extensively they do not show any associated problems.
Management
If after full physical examination and investigations no any abnormalities are found no therapy is given for haematospermia as it usually resolves spontaneously and reassurance is all that is required. Treatment of any associated or underlying pathology usually is sufficient.