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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Hematospermia?

I am a 54 yo male. I have had hemateospermia for the last 9 months. 90% of the time, the ejaculate contains bright red blood. When it initially happened, my GP put me on Cipro for a month, did a prostate exam (normal) and psa test (normal) and urinalysis (normal). After the Cipro did nothing, I was referred to a urologist. The urologist basically told me there was nothing more to do since I had a normal psa, normal urinalysis and normal prostate and said he thought it would go away, and if it did not in 3 months to return. So, three months later I returned as it did not get better. At this time, I was put on Bactrum DS for one month. As was the case before, the antibiotics did nothing. Because I was also feeling a slight pain in my right testicle, the urologist order an Testicular Ultra-sound (which also proved normal). My urologist says I am really at the end of the road for tests and there is nothing more they can do and that I will probably just have to live with it. Is this right? He offered to do a cystoscopy, but since I do not have any blood in the urine, he was confident that this test would also show normal... I am at wits end. I fell like something is really wrong and it really in not normal for a doctor to say -- just live with it.. but maybe so.. so I was looking for a second opinion. Thank you
Wed, 17 Apr 2019
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General & Family Physician 's  Response
Hi,

Hematospermia carries a lot of etiologies associated with it but certainly many a time it is iatrogenic, means when no reason could be diagnosed, and it resolves by itself. The essential tests have already been done and it is true that nothing more than that could be done. Sometimes malignant hypertension also causes such symptoms, for that I suggest BP examination. Also, you may go for coagulation studies to rule out any bleeding abnormality that may be presenting with hematospermia. Apart from that, there is nothing that can be done.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Maninder, General & Family Physician
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What Causes Hematospermia?

Hi, Hematospermia carries a lot of etiologies associated with it but certainly many a time it is iatrogenic, means when no reason could be diagnosed, and it resolves by itself. The essential tests have already been done and it is true that nothing more than that could be done. Sometimes malignant hypertension also causes such symptoms, for that I suggest BP examination. Also, you may go for coagulation studies to rule out any bleeding abnormality that may be presenting with hematospermia. Apart from that, there is nothing that can be done. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Maninder, General & Family Physician