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Biopsy Done For Enlarged Prostrate, Blood In Semen, Antibiotic, Blood In Urine

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Posted on Sat, 26 May 2012
Question: Blod in semen and urine
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I am a 77 year old male in excellent health. I have had an enlarged prostate and my Urologist did a biopsy. there were some suspicious sells but no sign of Cancer. He repeated the biopsy ab out 6 months later and here were no cancer cells. My PSA has always been normal.

About six months ago I began having blood in my semen. My urologist gave me some antibiotics but they were not successful. Blood does not always appear but sometimes is thick red. I have been taking XXXXXXX for enlarged Prostate but discontinued about three months ago because of side effects. I still get up only twice per noght to urinate and I can handle that.

Two weeks I notrced some blld on mu uriine. Not a lot and not every time I uninated. I am now faced with blood in semen and urine. My Urologist wants to do another biopsy since he doesn't seem to have a clue. I have the biopsy scheduled for later this month?

Help me understand what is going on and should I continue with the plan for a biopsy?

I have no pain in urination or ejactulation.

Thank you for your help.
doctor
Answered by Dr. Rajiv goel (2 days later)
Hi,
Thanks for writing in.
I understand your concern.
In my opinion, the blood in your urine and semen is probably an after effect of the biopsy and could be partially contributed to by an enlarged prostate.
I would suggest that a computerised tomography urogram (CT urogram) be done for you so that e can rule out other causes of haematuria (blood in the urine) and blood in the semen. If this is normal, e can safely attribute your symptoms to the biopsy and enlarged prostate.
Secondly, considering the fact that you have a normal prostate specific antigen level, there is no need to repeat a biopsy. Rather, you need to be started on an alpha blocker like tamsulosin and a 5 alpha reductase inhibitor like dutasteride. Both the agents together will help relieve the bleeding and also relieve you of your prostatic symptoms.
I think you should see your urologist again and discuss these treatment options with him.
I hope I have addressed your concerns. I shall be available for follow up queries.

Note: Consult a Urologist online for consultation about prostate and bladder problems, sexual dysfunction, kidney stones, prostate enlargement, urinary incontinence, impotence and erectile dysfunction - Click here.

Above answer was peer-reviewed by : Dr. Aparna Kohli
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Answered by
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Dr. Rajiv goel

Urologist

Practicing since :1998

Answered : 581 Questions

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Biopsy Done For Enlarged Prostrate, Blood In Semen, Antibiotic, Blood In Urine

Hi,
Thanks for writing in.
I understand your concern.
In my opinion, the blood in your urine and semen is probably an after effect of the biopsy and could be partially contributed to by an enlarged prostate.
I would suggest that a computerised tomography urogram (CT urogram) be done for you so that e can rule out other causes of haematuria (blood in the urine) and blood in the semen. If this is normal, e can safely attribute your symptoms to the biopsy and enlarged prostate.
Secondly, considering the fact that you have a normal prostate specific antigen level, there is no need to repeat a biopsy. Rather, you need to be started on an alpha blocker like tamsulosin and a 5 alpha reductase inhibitor like dutasteride. Both the agents together will help relieve the bleeding and also relieve you of your prostatic symptoms.
I think you should see your urologist again and discuss these treatment options with him.
I hope I have addressed your concerns. I shall be available for follow up queries.