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What causes continual hematospermia and intermittent hematuria?

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Posted on Tue, 26 May 2015
Question: Why do I continuously have problems with hematospermia and intermittent hematuria when I have had all the major workups that can't justify why I am plagued with this problem. I have also been on Cipro as well as Septra.
doctor
Answered by Dr. P. T. Patil (5 hours later)
Brief Answer:
Could be due to Prostatitis or Enlarged Prostate.

Detailed Answer:
Hello
Thanks for your query,based on the facts that you have posted it appears that you have hematospermia and intermittent hematuria since couple of months and have been investigated thoroughly but failed to trace out the cause of your symptoms.

I shall be happy if you can post me few more details to help me in making comments on your problem.
1) Are you taking any medications like Aspirin ?
2) Do you have other urinary symptoms like frequency for urination urgency.nocturnal frequency etc ?
3) Do you have painful ejaculation?
4) Do you have fever with chills any time during last few months?
5)Is it possible to upload the reports of the tests that have been carried out so far.?.

In view of absence of any positive evidence for your symptoms it should be considered to be due to infection of prostate (Prostatitis or Enlarged Prostate) The bleeding that you have could be from the superficial veins on the surface of congested prostate.

Doing endoscopic examination (Cystoscopy) when having active hematuria and hematospermia may perhaps help to find out the source of bleeding.

Please discuss about this with your Urologist.

In the mean while continue taking antibiotics.

Hope I have answered your query ,please feel free to ask if you have more questions I shall be happy to help you
Thanks and Regards.
Dr.Patil.





Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. P. T. Patil (10 hours later)
Hello,
No, I do not take aspirin. This has been going on for about two years. There is never any pain on ejaculation or otherwise, nor has there ever been any fever or chills. The blood in the semen will sometimes have reddish blood, then if I abstain from ejaculation for say 2-3 weeks it will then turn dark brown which indicates old blood. If I have no ejaculatory activity, it will begin to clear, only to re-occur. I told my urologist, I believe there is a ruptured or broken blood vessel in or around the prostate, he agrees. I had an MRI done of the prostate, they didn't see any ruptures, but did see the evidence of blood in the prostate. I want to know, what can be done to resolve this issue as it is effecting me not only physically but emotionally. I have also been on Cipro twice as well as Septra. My urologist suggested ejaculatory rest, but it's not working. I don't know what else to do. What is your recommendation.
Ray
doctor
Answered by Dr. P. T. Patil (33 minutes later)
Brief Answer:
Bleeding is likely from ruptured superficial vein of Prostate .

Detailed Answer:
Hello

Thanks for feedback.
I have come across the similar situation for couple of times in my long practice ..Doing Cystoscopic examination during active episode of bleeding helps to trace out source of bleeding which otherwise can not be detected on investigations like MRI or CT scan .

If the bleeding is from the surface of the prostate one can fulgurate the bleeding points or think of doing TURP.

This helps to stops the bleeding completely and for forever.

Please discuss this with your Urologist and if he agrees with me can go ahead with my suggestions.

Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. P. T. Patil (25 minutes later)
Yes, he did mention fulguration of the prominent blood vessels. Is this a painful process? Not familiar!
doctor
Answered by Dr. P. T. Patil (1 hour later)
Brief Answer:
It is not painful .The procedure is done under anesthesia

Detailed Answer:
Hello
Thanks for follow up.
The procedure is simple and short and is done under anesthesia.
Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. P. T. Patil (21 minutes later)
Thanks. I have sent my urologist an email requesting the fulguration procedure. I told him months ago that I believed it was prostate related. I am not a specialist, but sometimes you can just read between the lines to make sense of it all. I will let you know what he says when he responds. You have been very helpful.
doctor
Answered by Dr. P. T. Patil (20 minutes later)
Brief Answer:
Thanks for appreciation

Detailed Answer:
Hello
Thanks for appreciation about my suggestions .
Please do write once you hear from your urologist and any further procedure that be carried out.
Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Follow up: Dr. P. T. Patil (2 days later)
Hello,
I meant to ask you about one of your previous responses. You said if the bleeding is from the surface of the prostate one could fulgurate the bleeding points and this should stop the bleeding. Aside from the surface of the prostate, is there another area of the prostate where blood vessels are present that could produce bleeding as well?
doctor
Answered by Dr. P. T. Patil (2 hours later)
Brief Answer:
Usually superficial vesseles bleed

Detailed Answer:
Hello
Thanks for follow up.
It is usually superficial veins those bleed to congestion and erosion.
Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. P. T. Patil (33 minutes later)
OK, Again, I have had all the major workups that produced nothing substantial, I have been on 2-3 courses of antibiotics, and still the hematospermia and intermittent hematuria have been persistent. Would you say that the issue with my bleeding is most likely the blood vessels on the prostate? I am scheduled to speak with my urologist tomorrow to discuss the fulgurating of the blood vessels. I have tried everything else, I truly believe the problem is with the blood vessels at the prostate. Do you agree?
doctor
Answered by Dr. P. T. Patil (30 minutes later)
Brief Answer:
This is the only possibility we can think as of now.

Detailed Answer:

Hello
Thanks for follow up.
In absence of any positive finding from all the investigation this is the only possibility of that we can suspect to be,
thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. P. T. Patil (8 hours later)
Thank You. I will keep you posted. I value your opinion.
doctor
Answered by Dr. P. T. Patil (1 hour later)
Brief Answer:
Please go ahead and let me hear from you.

Detailed Answer:
Hello
Thanks for follow up.
Please go ahead and do write to me if you need my help.
Thanks and Regards,
Dr.Patil.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. P. T. Patil

Urologist

Practicing since :1971

Answered : 10340 Questions

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What causes continual hematospermia and intermittent hematuria?

Brief Answer: Could be due to Prostatitis or Enlarged Prostate. Detailed Answer: Hello Thanks for your query,based on the facts that you have posted it appears that you have hematospermia and intermittent hematuria since couple of months and have been investigated thoroughly but failed to trace out the cause of your symptoms. I shall be happy if you can post me few more details to help me in making comments on your problem. 1) Are you taking any medications like Aspirin ? 2) Do you have other urinary symptoms like frequency for urination urgency.nocturnal frequency etc ? 3) Do you have painful ejaculation? 4) Do you have fever with chills any time during last few months? 5)Is it possible to upload the reports of the tests that have been carried out so far.?. In view of absence of any positive evidence for your symptoms it should be considered to be due to infection of prostate (Prostatitis or Enlarged Prostate) The bleeding that you have could be from the superficial veins on the surface of congested prostate. Doing endoscopic examination (Cystoscopy) when having active hematuria and hematospermia may perhaps help to find out the source of bleeding. Please discuss about this with your Urologist. In the mean while continue taking antibiotics. Hope I have answered your query ,please feel free to ask if you have more questions I shall be happy to help you Thanks and Regards. Dr.Patil.