question-icon

What causes blood in the ejaculate and shrunken penis?

default
Posted on Wed, 27 May 2015
Question: Hello - I'm a 70 year old male in generally good health. I take 20 mg of benazepril for my blood pressure and walk 2 miles a day. I also have a mild inguinal hernia resulting from a surgery I had when I was 18 years old, but it never really bothered me until recently. I've also had a vasectomy about 25 years ago. My PSA levels at my last physical were good (according to the doctor). Today, while I was sitting waiting for my car to get repaired, my hernia was bothering me a bit as my belt had dropped around it. When I went home, I noticed blood in my urine (the very first time in my life!) just at the beginning of urination, but not afterwards. I drank scads of water and the blood flow greatly diminished and then mostly disappeared. Since I had not had sexual intercourse with my wife for several years (she is very depressed), I decided to masturbate just to see what happened. I hadn't ejaculated in over 2 years for religious reasons. The bottom line is that there was some blood in the ejaculate, and there seemed to be some diluted blood drops at the end of my penis. There is no noticeable burning or other discomfort and I have not had sex outside of my marriage. Also, my penis seems to have shrunken quite a bit (if that makes any sense to you) I'm going to make an appointment with a urologist tomorrow. Absent any diagnostic testing, what could be the problem??
doctor
Answered by Dr. T Chandrakant (40 minutes later)
Brief Answer:
Hematospermia - stop baby aspirin - ask for all the tests

Detailed Answer:
Hi.
Thanks for your query.
Read and understood your history well.
To recapitulate: Male/70 - under medicines for BP (20 mg of benazepril, 12.5 mg hczt, simvistatio and a daily baby aspirin) - inguinal hernia using belt - vasectomy - PSA good - no sex or ejaculation for the dais reasons - blood in the beginning of urination - masturbated to see - blood in the ejaculate - and at end of penis - shrunken penis (understood with the age and no sex, no relation to the present problem) -

The probable problems:
With the history you have provided, this we can say for practical purpose hematospermia.
In most of the cases the reason is obscure.
In your case must be related to the congestion of the prostate as there is no out-letting the semen (mostly contains the prostatic fluid).
Since vasectomy has already been done, the blood is no coming from the scrotum.
The blood in the beginning of urination and in the semen after masturbation indicates the source to be from the prostate.

I am sure your Urologist will definitely go for the routines of a case of Hematospermia.
I shall be waiting to see the reports and results of the clinical evaluation and examinations and tests.
Please ask him about the baby aspirin you are taking, i think it should be stopped till the results are finalized (increases the chances of bleeding due to anti-platelet activities)

Since PSA was normal, there must be a benign lesion causing this problem.

I hope this answer helps you to get a proper diagnosis, and get a proper further treatment. Please feel free to ask for more if you need to or if you feel that there is a gap of communication.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. T Chandrakant (13 hours later)
Hi Doc - thanks. The PSA was normal last year, but I didn't have a PSA test this year (yet). This morning, I passed 2 small blood clots but everything has been fine since. The inguinal hernia was repaired when I was 5 years old - double inguinal hernia - one side held properly, but the other side gradually began to open up. I remember it starting when I was 18 playing tennis. It didn't cause me any problems then and I passed the Navy's flight physical with it, but recently it's gotten longer and it does tend to ache if I sit for a long time and / or if my belt is tight. My belt tends to slip down under my belly. This is precisely what happened yesterday while I was waiting to get tires on my car. I'll ask the urologist if this could have somehow irritated the prostate. In any case, I'll get this fixed. I'll ask him about the baby aspirin and I won't take it for a couple of days.

Also, I had a very quick and strange case of the flu about 10 weeks ago - very sudden onset, dizziness (no fever). It left me with an intermittent nagging pain in my left knee and (sometimes) in the instep of my right foot. I took teraflu and was out plowing snow in just 2 days. I wonder if this somehow also settled in my prostate?
doctor
Answered by Dr. T Chandrakant (34 minutes later)
Brief Answer:
Get hernia operated and viruses do not affect prostate.

Detailed Answer:
Thanks for your feedback in an elucidate way.
Enlarging Inguinal hernia may not at all irritate the urinary bladder, unless the hernial sac comprises the sliding component of hte urinary bladder, but then the whole urine would have been red, not as you explained.

Please get the hernias operated.
Flu 10 weeks ago with associated symptoms may not be related to the prostate. The viruses do not cause such infections or changes in the prostate.

I hope this clarifies.
You may please rate this answer before closure of the discussion and can certainly contact me on the bellow link in future, whenever you may need me.
http://bit.ly/askdrtchandrakant
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. T Chandrakant

General Surgeon

Practicing since :1984

Answered : 19459 Questions

premium_optimized

The User accepted the expert's answer

Share on
What causes blood in the ejaculate and shrunken penis?

Brief Answer: Hematospermia - stop baby aspirin - ask for all the tests Detailed Answer: Hi. Thanks for your query. Read and understood your history well. To recapitulate: Male/70 - under medicines for BP (20 mg of benazepril, 12.5 mg hczt, simvistatio and a daily baby aspirin) - inguinal hernia using belt - vasectomy - PSA good - no sex or ejaculation for the dais reasons - blood in the beginning of urination - masturbated to see - blood in the ejaculate - and at end of penis - shrunken penis (understood with the age and no sex, no relation to the present problem) - The probable problems: With the history you have provided, this we can say for practical purpose hematospermia. In most of the cases the reason is obscure. In your case must be related to the congestion of the prostate as there is no out-letting the semen (mostly contains the prostatic fluid). Since vasectomy has already been done, the blood is no coming from the scrotum. The blood in the beginning of urination and in the semen after masturbation indicates the source to be from the prostate. I am sure your Urologist will definitely go for the routines of a case of Hematospermia. I shall be waiting to see the reports and results of the clinical evaluation and examinations and tests. Please ask him about the baby aspirin you are taking, i think it should be stopped till the results are finalized (increases the chances of bleeding due to anti-platelet activities) Since PSA was normal, there must be a benign lesion causing this problem. I hope this answer helps you to get a proper diagnosis, and get a proper further treatment. Please feel free to ask for more if you need to or if you feel that there is a gap of communication.