Hematospermia is defined as blood in the semen. While often perceived as a symptom of little significance, blood in the ejaculate can cause great deal of concern to those men who experience it. Hematospermia is not uncommon and may affect men of any age, but its peak incidence is in men 30 to 40 years of age. About 85 to 90 percent of all patients who have hematospermia will have repeated episodes. Blood present in semen can be caused by many conditions affecting the male genitourinary system. Areas affected may include the bladder, urethra, the testicles, the tubes that distribute semen from the testicles (known as the seminal vesicles), the epididymis (a segment of the spermatic ducts that serves to store, mature, and transport sperm), and the prostate gland. Some known causes of hematospermia include:
- Infections (including those that are sexually transmitted)
- Inflammation of the bladder, prostate, or related areas
- Injury to the genitals
- Trauma or medical procedure
- Polyps in the urethra
Symptoms
Some of the common symptoms associated with hematospermia include the following:
- Painful urination
- Pain during ejaculation
- In addition to blood in semen, the patient may often complain of blood in urine
- Lower back pain with tenderness and swelling in the scrotal region is common symptom
- Low grade fever with reduced appetite and generalized weakness may also be experienced in some cases
How Is Hematospermia Diagnosed?
A number of diagnostic tests may be performed after the clinical history is evaluated and a physical examination is performed. Some of the most commonly performed diagnostic tests are a urinalysis and cultures to identify any sexually transmitted diseases or other infections. When indicated, imaging technologies such as an ultrasound or MRI may reveal tumors or other abnormalities. In some situations, a semen analysis, in which the semen is analyzed under a microscope, may also be recommended.
Treatment
Depending on the causes of the condition, the urologist can prescribe or recommend several forms of treatment. In the case of inflammation and infection, anti-inflammatory medication and antibiotics are typically used. Meanwhile, if hematospermia is caused by other medical conditions, such as prostate cancer, treating the underlying condition will resolve the problem. In many cases, if the presence of blood in the semen is not associated with a known abnormality or worrying symptoms, no treatment is given, because the symptoms often disappear without a specific remedy.