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Have Recurrent Hematospermia. Suggest Some Permanent Treatment

Posted on Wed, 9 Jan 2013

Question: Dear Urologist, I have recurrent hematospermia. First episode was one year which spontaneously resolved without treatment. One year ago Had a abdominal Ultrasound which was suggestive of calculi in or around the prostate. Did not undergo a TRUS. Now my hematospermia recurred. Initially I noticed some heat and tingling XXXXXXX inside my penis while getting aroused during the initial phases of masturbation. Then during midpoint of masturbating I notice some bright red blood which made me stop masturbating. Then as I tried to urinate I had some pain, resistance and eventually urinated a few blood clots followed by clearing. Unfortunately this has recurred twice more in a week. I masturbated today and noticed bright red blood with the ejaculate sperm.

Answered by Dr. Mahesh Koregol (5 hours later)

Hi,

Thanks for your query. I read your query and understand your concerns. Following is my reply:

1) The symptoms you are describing could be related to calculi and its complications.

2) Calculi anywhere in urinary tract flow down. When small calculi try to come out through narrow urethra, they cause pain as well as bleeding.

3) Since ultrasound has already demonstrated calculi around prostate, I advice you to undergo a procedure called cystoscopy.

4) Cystoscopy is a procedure in which calculi are directly visualised using a scope. If there are any calculi in bladder or urethra causing the problem, they can be removed at the same time which is a treatment.

5) Please visit a urologist for the same. Probably there is a calculi in urethra which is causing the above symptoms and need to be removed by cystoscopy.

I hope I answered your query.

Regards,
Dr.Mahesh Koregol

Above answer was peer-reviewed by : Dr. Mohammed Kappan

Follow up: Dr. Mahesh Koregol (6 hours later)

Dear Dr. XXXXXXX Koregol,
I appreciate your prompt response. Just to confirm, I forgot to emphasize that my hematuria was only secondary to the hematospermia. I have never had any pure instances of hematuria without it being related to hematospermia or blood from my pre-ejaculate.
Based upon these symptoms, from an anatomical standpoint, is it possible that a stone or several small calculi or lodged somewhere in the vas deferans or seminal vesicles or some other part of the genitourinary stream other than urethra or the bladder? I just feel that my primary problem is not in the urinary tract like traditional kidney stones as I've never had any of the other upper or lower urinary tract symptoms (of renal colic associated with nephrolithiasis).
My next concern is of some type of unusual infection XXXXXXX inside the genitourinary system or prostate gland. I have had occasional red streaks on my glans penis but no other stigmata of an STD or visible condyloma from HPV. But XXXXXXX inside my head I wonder if there is some type of HPV related infection internally causing periodic sloughing, tissue breakdown followed by hematospermia and blood in the pre-ejaculate.
One last thing I forgot to mention is that I periodically use Cialis. Is it possible that this is also contributing to my bleeding?

Thank you in advance for thoroughly answering my question.

Answered by Dr. Mahesh Koregol (2 hours later)

Hi, glad to see your reply.

Following is my reply :

1) The trauma due to calculi is more pronounced in erectile state. If not due to violent masturbation, the only other possibility is calculi ad you have rightly mentioned.

2) Please get your urine and sperm culture done. It will bring out any organism possible for infection.

3) Cialis is unlikely to produce such bleeding. I don't think that could be the cause.

Let me know if you have any more doubts.

Regards,
Dr XXXXXXX koregol

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Above answer was peer-reviewed by : Dr. Shanthi.E