Where does blood come from?
Seminal fluid is formed from the secretion of the prostate gland, seminal vesicles and the contents of the vas deferens. Accordingly, the source of blood can be any of these structures, as well as the urethra.
Most often, the seminal vesicles and prostate bleed: these are structures with abundant blood supply and thin vessel walls that are easily damaged by inflammation, increased pressure or after manipulation.
The color of the ejaculate can range from pinkish to dark brown. A dark color usually means the blood has been there for a while and is no more alarming than bright red.
Reasons
- Inflammatory: prostatitis, vesiculitis, urethritis, epididymitis - the most common group
- Sexually transmitted infections
- Consequences of medical interventions: prostate biopsy, cystoscopy, catheterization, brachytherapy - a very common and completely expected cause
- Prostate adenoma
- Prostate and seminal vesicle stones
- Cysts of seminal vesicles and prostate gland
- Injuries to the perineum and genitals
- Prolonged abstinence followed by intense sexual activity
- Arterial hypertension, especially uncontrolled
- Taking anticoagulants and bleeding disorders
- Tumors: prostate cancer, less commonly cancer of the seminal vesicles and bladder
- Tuberculosis of the genitourinary system
- Idiopathic hemospermia - the cause cannot be found; common
- Partner's blood mistaken for hemospermia
When you don't have to worry
- Age under forty
- Single episode or multiple episodes over a short period of time
- No pain, urination problems or blood in the urine
- Recent medical intervention on the prostate or urethra
- Normal urinalysis and PSA values
- No risk factors and good general health
In such a situation, an examination by a urologist, a urine test, testing for infections and observation are usually sufficient. Special treatment is most often not required, and the episodes resolve spontaneously within a few weeks.
When is a full examination needed?
- Age over forty years is the main criterion
- Episodes repeat for more than a month
- At the same time there is blood in the urine
- There is pain during ejaculation, pain in the perineum, urination problems
- Increased PSA level
- There are general symptoms: weight loss, weakness, fever
- Have cancer risk factors or family history
- Hemospermia while taking anticoagulants requires an assessment of both the drug itself and urological causes
Diagnostics
- Examination by a urologist with digital rectal examination of the prostate
- Urinalysis and culture
- PCR for sexually transmitted infections
- PSA in men over forty years of age - but not in the acute period of inflammation
- TRUS of the prostate and seminal vesicles is the main imaging method
- Ultrasound of the kidneys and bladder
- Spermogram
- MRI of the pelvis for suspicious findings
- Cystoscopy in combination with blood in the urine
- Coagulogram and blood pressure control
- Prostate biopsy - with elevated PSA and suspicious MRI findings
Treatment
- Observation - for single episodes in young men without risk factors
- Antibacterial therapy for confirmed infection
- Anti-inflammatory treatment for prostatitis and vesiculitis
- Treatment of sexually transmitted infections with examination of the partner
- Blood pressure control
- Correction of anticoagulant therapy together with a cardiologist
- Removal of prostate stones and seminal vesicle cysts if significant
- Endoscopic treatment for identified source of bleeding
- Treatment of detected cancer
- Sexual rest for a short period during severe episodes - as recommended by a doctor
Where to get examined in Tashkent
The examination includes an examination by a urologist, tests, TRUS and, in older men, a PSA determination.
In Tashkent, such an examination, including prostate biopsy when indicated, is carried out at the UROLOGIC COMPLEX medical center and at the Tashkent Medical Park clinic.
If you are under forty and the episode was a one-time occurrence, there is most likely nothing to worry about, but you should still see a urologist. If you are over forty or the episodes are repeated, an examination is mandatory and should not be postponed. Clinic contacts are below.
