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Have soreness in testicles. Noticed blood after sex. Would blood in urethra cause blood in bladder?

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Practicing since : 1995
Answered : 517 Questions
If your bleeding is due to a ruptured blood vessel involving the prostate, Finasteride might help in reducing the congestion.
However, it needs to be taken on a fairly long term basis for it to show positive effects. On the other hand, if you are bleeding every time you are aroused, we cannot wait till the medicine takes effect, which can take up to and over 6 months.
MRI is not a bad idea, as it will show any disease involving the prostate and seminal vesicles, which can be tackled depending on the nature of the finding on the MRI. But you have to realize that there is a significant possibility of the MRI also turning out to be normal, in which a problem in the urethra also should be suspected.
This urethra is the passage which conducts urine and semen to the exterior, and any inflamed vessel could also be causing the problem you are facing. This can be ascertained by means of a test called retrograde urethrogram which might show up a more obvious lesion. On the other hand, it will almost certainly miss the more subtle ones, in which case further tests like angiogram / venogram of the pelvic vasculature might be required. The last step should be a cystoscopy and urethroscopy which should be able to tell us where the bleeding is coming from, and also provide us with an opportunity to treat the matter in the same sitting.
As your urologist seems have pointed out, we are handicapped by the fact that this is a very unusual picture, and therefore treatment cannot be guided only by one's own experience which is likely to be very limited.
Hope I have been able to help you.
Replied by Dr. V. Sasanka , Sun, 5 May 2013     
This is how you answered my question I'm very impressed but would bleeding in my uretha cause blood in my bladder during sex sometimes it will come out the end of my penis but mostly in my bladder and it seems to happen while having sex not just ejaculation could it be coming from testicles I feel soreness above my testicles
Posted Thu, 20 Jun 2013 in Men's Health
Answered by Dr. V. Sasanka 1 hour later
Bleeding occurring at the onset of urination or towards the end of voiding urine usually suggests a problem in prostate / prostatic urethra / bladder neck.
Prostate congestion can typically cause a mild aching pain, discomfort, soreness in lower abdomen or perineum, i.e. adjacent to your testicles. This might be the discomfort what you are experiencing. This can be assessed by means of a test called trans-rectal ultrasound study which will reveal any local pathology in the prostate, seminal vesicles, ejaculatory ducts, and prostatic urethra, and also any local increase in vascularity suggestive of inflammation. It is an invasive technique (in the sense, it will involve the radiologist placing an ultrasound probe into your rectum) but I think there is a significant chance of picking up the cause of your trouble with this examination.
If this turns out to be not useful, you might require the other tests we discussed earlier, viz cystoscopy, MRI, etc.
Hope you get well soon, and please let me know the progress. I will be more than happy to clarify any further doubts.
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Follow-up: Have soreness in testicles. Noticed blood after sex. Would blood in urethra cause blood in bladder? 7 hours later
Let me ask you the day this all started my wife and I were having rough sex and using a cock ring could this be the reason I got blood did this cause some kind of rupture and if so where would the rupture most likely be
Answered by Dr. V. Sasanka 1 hour later
Yes - what you did mention now looks like it could have caused the problem that you have at present.
The common area involved is what we call 'penoscrotal junction' but I would rather not hazard a more specific guess unless you get those tests done which I mentioned earlier. They will be able to localize the disease process much better, following which the actual treatment can be planned.
Above answer was peer-reviewed by
Follow-up: Have soreness in testicles. Noticed blood after sex. Would blood in urethra cause blood in bladder? 2 hours later
Amazing I looked that up do you think this issue would cause blood to fill my bladder during sex is this why some times I see it both directions to be completely honest I seen it immediately during the rough sex and it immediately plugged bladder but I was to embarrassed to say anything to my doctor the mri came back clean would this not show up will it adventually heal on its own and if this was the condition is that why I feel upper pain behind my testicals do you think this may be the irritation from the blood vessel healing I can get blood on call I don't see blood during masterbation but three minutes into sex with pushing and pulling and her weight on me the problem materializes also can they fix this problem at the very least with surgery all my test came back good so far so I have to believe this may be the closes I have come so far

Oh ya it's a lot of blood when it ruptures but the wired thing is as soon as sex stops the bleeding stops and clears up leaving sore XXXXXXX
Answered by Dr. V. Sasanka 10 hours later
I am not surprised by what you have mentioned. Quite often urethral bleed ebbs back into the bladder and comes out along with urine.
At this point, I cannot say for certain that the pain that you experience behind the testicles is due to this present problem. I only wish the problem would resolve on its own, but if the vessel involved is large, or if there is an abnormal communication, it may need a urologist's intervention. Maybe you should see if you abstain from intercouse for some time and see if the condition settles down. But on occasions such a bleed could also be triggered by a simple erection alone, and that will be relatively more difficult to abolish.
As I said earlier, the bleeding is most likely from the urethra which is the normal passage for urine. The pathology in urethra shows up more clearly on a special X-ray called Retrograde urethrogram (RGU). If this is done soon after an episode of urethral bleed, the contrast medication might even extravasate into the bleeding vessels.
Cystoscopy is done usually as the last investigation, and usually the urologist would be prepared to tackle any bleeder if it comes into view so that a repeat procedure is not required.
Hope you get well soon.
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Follow-up: Have soreness in testicles. Noticed blood after sex. Would blood in urethra cause blood in bladder? 11 minutes later
So why does it only bleed on arousel is it because increased blood pressure on arousal
Answered by Dr. V. Sasanka 22 minutes later
The urethra gets stretched at the time of erection. If there is a tear of the urethra, this will cause the edges of the tear to split open, and bleeding will resume. The mechanics of erection is the cause here, and that is the reason why I suggested that you avoid intercourse for a couple of weeks if possible. A hot blooded male normally has erections early in the morning even without arousal or stimulation, and there are several urologists who actually give medicines to suppress early morning erections to help urethra heal after minor surgeries. This is likely to work well for you, and you might actually avoid surgery, but these are medicines that will be available only when your doctor prescribes them.
Let me know what your urologist suggests, or if there is a problem.
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Follow-up: Have soreness in testicles. Noticed blood after sex. Would blood in urethra cause blood in bladder? 22 hours later
What I don't understand is if I have 3 minutes of sex or masterbation and have a climax there is no blood anything more than 3 minutes the blood will show its self every time and will bleed a lot into my bladder And out my penis Is this because the urethia is weak and it just takes more time for it to burst and is it a group of blood vessels that have been weakened possibly a tear that is stretched with erection that gives away and burst So is this why the blood stops when the erection goes down does it shrink the urethia closing the tear up stopping the blood just leaving the feeling of soreness from trauma Sorry in advance to ask so many questions but I've been referred to ucsf of San Francisco which in theory is a much better hospital with much more experience and I want to ask all the rite questions to my new doctor the old one took it as far as he could but new to refer me for more help Do you know of this hospital? And if so what is your option
Answered by Dr. V. Sasanka 19 minutes later
I am afraid I am not familiar with the hospital to which you have been referred, but if your local doctor feels they will do a better job, by all means, please go ahead.
I would still advise you to desist from sexual relationships for the time being, so as to give the tear a chance to recover, which it will, unless there has been an anomalous connection which as been established with the urethra and what we call 'corporae' which are tubular blood filled structures which help maintain normal erection (The chance of this happening is quite rare, so please do not fret unnecessarily).
More likely the tear in urethra is getting split open whenever there is a stretch on the penis - As I said earlier, this is quite commonly seen when we do a procedure called urethrotomy for patients who have strictures - narrowings - of urethra. If this occurs in an area of urethra called penoscrotal junction or penile urethra, bleeding happens whenever the patient develops an erection. This is quite common, and during this period, we do give patients drugs to suppress erections. Some times bleeding can become quite severe, and then we do what we call perineal packing, and on occasions have had to take the patient back to the operation theatre to control the bleed.
I think we can try an analogy here - Imagine a cut in your skin in a limb near the elbow or knee. Even if the cut is deep and has not been sutured, the cut ends will eventually come together, but during this period of healing, the ends should not be separated. If the edges keep coming apart due to active mobility due to the area being close to a joint, the wound would bleed and take longer to heal. More vigorous the activity, higher would be the chances of the wound edges getting separated. So in your case, more vigorous the sexual activity or the longer it takes, more is the stress on the urethra, and promptly it bleeds. Either way, the best option would be to go to a center which as all the equipment in the armory to tackle this scenario.
Let me know what is the progress.
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Follow-up: Have soreness in testicles. Noticed blood after sex. Would blood in urethra cause blood in bladder? 19 minutes later
But it only happens after 3 minutes of sex could this take this long for the erection to cause the urethia to tear it does to happen as soon as I get an erection in the beginning four months ago I would have blood every nite when i woke up and with instant arousel it took a week or two and the blood did not come as easy do you think this is still urethia
Answered by Dr. V. Sasanka 5 minutes later
Yes - I still think the urethra is the culprit, unless there is anomalous connection which I mentioned earlier. Either way, without further investigations, there will no point in my speculating at this juncture. I suggest you also quite worrying about this right now, and take your time to visit the hospital which as been recommended by your local doctor. You can voice your apprehensions there, and you can also mention the feedback which you have received through these columns, and see what the urologist at UCSF have to suggest.
Above answer was peer-reviewed by
Follow-up: Have soreness in testicles. Noticed blood after sex. Would blood in urethra cause blood in bladder? 6 minutes later
At the very least thank you I feel much better now that you help shed some light on XXXXXXX different scenarios I was real worried that I would have to live with this condition and its been stressing me out for I have been to uroligist repeadly for the last four months and have become very tired from stress and have been anxious to get to my new doctor to get help Anyway ill keep you posted on the results

Thanks in advance
Answered by Dr. V. Sasanka 47 hours later
Sure, I will be pleased to address your concerns in future. You can write back to me on this link: WWW.WWWW.WW
Good luck!!!
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