Blood in semen or hematospermia or Hemospermia

  Blood in semen or hematospermia or Hemospermia 

Although the presence of blood in semen is often considered a minor symptom, blood in ejaculation or semen in men who have it and remain positive for a long time is extremely important.

This condition is very common and occurs several times without special attention to the patient.

The prevalence of the disease has not yet been determined.

 Cancer, infection, anatomical abnormalities, abnormalities, stones, and inflammation in many parts of the urinary tract are also factors in the presence of blood in the semen.

Important and rare causes of blood in semen:

1- The most common cause of blood in semen is prostate biopsy.

2- Benign prostate enlargement (BPH)

This is because BPH causes the prostate to enlarge and put pressure on the urinary tract (resulting in rupture of blood vessels in these ducts).


3- We saw prostate infection, duct infection and epilepsy

4- Prostate cancer

5- Cancer of the seminal vesicles and testicles

About 3.5% of people who see blood in their semen actually have a tumor.

Most of these tumors are usually present in the prostate.

However, blood in semen can be linked to testicular cancer, bladder cancer, and other cancers of the genitals and urethra.

Men, especially older men who are at risk for cancer; If blood is seen in the semen, it should be examined.

Cancer is one of the life-threatening diseases if left untreated.

Benign polyps that are present in the genitals and usually do not cause any medical problems can cause blood in the semen.



6- Obstruction of the ducts

Each of the small tubes or canals in the genitals can become blocked. Obstruction can cause blood vessels to rupture and release small amounts of blood.


Infection or inflammation, which are other and relatively common causes of the disease.

Inflammation or infection in any of the gonads or ducts, which produce substances that move sperm and semen into the urethra, can lead to blood in the semen. These glands are:

Prostate (a gland that makes up a large part of semen secretion)

Duct (urinary tract)

Epididymis and diphtheria (small tubular structures in which sperm mature before ejaculation)

Semen sacs (which increase semen secretion with its secretions)

Out of every 10 people with blood in the semen, the cause is:

In 4 people, inflammation or infection of the gonads is the cause of blood clots.

Of the five people who have a prostate biopsy, four have the condition.

Blood in semen can also be caused by sexually transmitted infections or STIs such as gonorrhea or chlamydia, or by other bacterial and viral infections.



Importance of blood in semen:

The presence of blood in the semen causes the patient anxiety and is not always a sign of an important medical problem in people younger than 40, especially if there are no symptoms or risk factors or underlying disease in the patient, the disease often improves spontaneously, even if action is taken. No treatment.


When blood in the semen is formed in people over the age of 40-50 and does not last long, the problem is to have a urine test, a prostate exam, and a PSA test, but only if the disease is prolonged (more than two months). No further investigation is needed for an unknown cause.


 If it occurs in people over the age of 40 or 50, it needs to be checked and treated.

When is it dangerous to see blood in semen and need treatment?

They see blood in their semen frequently.

They see related symptoms when urinating or ejaculating.

They are at risk for cancer, bleeding disorders (coagulation) or other diseases.


Other causes of blood in semen

Actions used to treat urinary problems cause bleeding and usually stop a few weeks after the bleeding.

Masturbation, genital trauma, pelvic floor therapy, and vasectomy can cause blood in the semen.

In a study of 900 patients with blood in the semen (hematospermia), only 3.5 percent of the 900 people had cancer, most of them in the prostate.

High blood pressure, leukemia, and liver disease are other blood factors in semen.

All the structures and glands involved in ejaculation are made up of delicate vessels, and for example, the discharge of semen from the prostate due to trauma leads to rupture of the prostate vessels and makes the semen bloody.

Symptoms of seeing blood in semen

15% of people with this disease (blood in semen) are not necessarily for the above reasons, and many people with this disease get better after a period of 1 or 2 months.

People with the disease should pay special attention to the symptoms of pain and burning sensation, feeling full of bladder, difficulty emptying the bladder, painful ejaculation, urethral secretions, fever and chills.

Patients with a history of the disease who have a long history of the disease usually experience symptoms of fever and chills, weight loss, and associated bone pain. In young people, there is no need to do any tests, and the disease will improve on its own.

Several other causes include bloody semen, including prolonged sexual intercourse, sexual abstinence during intercourse, multiple sexual intercourse, or masturbation.

Testing and evaluation

Your doctor will ask you a complete medical history to detect blood in your semen; Including a history of any recent sexual activity.

The doctor will also perform a physical examination, which includes examining the genitals to diagnose lumps or swelling.

The doctor will also perform a digital examination of the anus to check for swelling, tenderness, and other symptoms associated with the prostate.

Your doctor may ask you to do the following tests:

- Analysis or urine culture tests to diagnose infections and other disorders

- STD test (sexually transmitted diseases); If you think you have a sexually transmitted disease.

Note: If there is a suspicion of infection, it is best to perform a sperm analysis test with culture of semen and duct secretions based on the results of culture and antibiogram response to specific antibiotic treatment.

Note: First, culture was performed through duct secretions (with examination in terms of gonorrhea) and then the patient underwent masturbation by sampling his semen sample in a sterile container. , Chlamydia, mycoplasma (generally recommended for complete STI paneling).


- Condom test; If there is a possibility that the blood in the semen is actually due to the blood of your partner's menstrual cycle; The man is asked to use a condom and, after ejaculation, to see if there is blood in the semen poured into the condom.

- PSA test; This test is done to check for prostate cancer by measuring a substance called prostate-specific antigen in the blood.

Other urological tests, such as cystoscopy, ultrasound, sciatica, and MRI, are also recommended for further examination.


Method of treating blood in semen

The following treatments are used to treat known causes:

Antibiotics are used to treat the infection. Although the patient's infection is not confirmed, it is best to give a two-week course of broad-spectrum antibiotics such as cephalosporins or penicillins.

Anti-inflammatory drugs may be prescribed for some types of inflammation.

If a sexually transmitted disease or other medical condition, such as high blood pressure or liver disease, is the cause of blood in the semen, your doctor will treat it.

When the blood in the semen is due to a urological procedure such as a prostate biopsy, treatment is usually not needed and the disease resolves spontaneously within a few weeks.

If young men see blood in their semen, and it only happens once or twice, and they have no additional symptoms or a history of a specific disease, they usually recover without the need for treatment.

If you have frequent blood clots in your semen and you have symptoms such as painful urination or painful ejaculation, your doctor may refer you to a urologist.

If your doctor suspects prostate cancer or other types of cancer, he or she may order a prostate biopsy to look for cancer.

Prostate cancer is less likely to occur in young men; Only about 6 percent of prostate cancers occur in men under the age of 45.

But for men who are at risk for cancer, at any age; Tests that rule out prostate cancer may be the most reassuring part of the treatment for the complication of blood in the semen.

Putting a catheter in the urethra, manipulating the urethra, or treating urinary symptoms with a device that may cause blood in the semen usually heals on its own after a few weeks. In such cases, the hematospermia usually improves after ten sexual intercourses.


Background diseases in a person that causes blood ejaculation should be treated before the main treatment.

Many patients who respond well to treatment do not need to be monitored. In patients with recurrent hematospermia or prolonged illness or with symptoms and the cause of the disease has not been determined, follow-up is required for three to six months to re-examine the symptoms.

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