Haematospermia is the presence of blood in the semen. In the majority of cases this is an entirely benign condition and does not cause any problems for the patient or their partner. It is generally self-limiting but repeated blood in the semen does require investigation.
There could be a number of possible causes for blood in the semen. It could be difficult to identify a single cause. The causes include (1) genital tract infection (2) generalised blood related conditions e.g. clotting disorders, or anticoagulants drugs; (3) recent history of urological surgery such as cystoscopy, bladder or prostate biopsy or vasectomy; (4) prostate or seminal vesicle abnormalities such as stones, cysts and rarely prostate cancer.
A consultation and examination will determine whether further investigations are required. If investigations are deemed necessary depending on the age of the patient or the pattern of bleeding then an ultrasound scan of the prostate and seminal vesicles is performed, together with an analysis of the urine and semen. Occasionally prostatic cysts, inflammation or prostatic stones are diagnosed.
This often detects prostatic cysts, prostate or seminal vesicle inflammation or prostate or ejaculatory dust stones are diagnosed.
For persistent haematospermia, any underlying cause is treated first. If there is any evidence of infection then a course of antibiotics can resolve the problem. In troublesome haematospermia a diagnostic camera test into the urethra (cystoscopy) is also performed, particularly in men of an older age group, to ensure that no abnormality is present near the ejaculatory ducts. Where there is blood in the seminal vesicles, a seminal vesicle washout can be offered. However, in the majority of individuals the underlying cause may not be identified and the condition is self limiting.