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Blood In Semen (Haematospermia) : Diagnosis, Treatment, Prognosis


Complications
Risk factors
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Diagnosis of Haematospermia
A number of diagnostic tests may be performed after the clinical history is evaluated and a physical examination is performed.

History
Your doctor will ask you multiple questions which may include:
  • When, how often, associated symptoms
  • Any precipitating factors
  • Any discharge or history of sexually transmitted infections
  • Pain on ejaculation, perineal pain, testicular pain
  • Bruising or bleeding tendencies
  • Problems urinating
  • Hypertension
  • Travel history, especially Africa


Physical Examination
A full physical examination is mandatory including:
  • Blood pressure
  • Abdominal palpation for hepatosplenomegaly or renal enlargement
  • Examination of genitals, including the testicles for any lumps, urethral discharge
  • PR prostatic check for cragginess, enlargement or lumps, loss of median sulcus


Tests
Some of the most commonly performed diagnostic tests are a urinalysis and cultures to identify any sexually transmitted or other infections. When indicated, imaging studies such as ultrasound or MRI may reveal tumors or other abnormalities. In some situations, a semen analysis, in which the semen is analyzed under a microscope, may be recommended.

Treatment of Haematospermia
In most cases, if blood in the semen is not associated with any known abnormality of other troubling symptoms, no treatment is given, and the condition usually resolves on its own with time in these situations. Persistent hematospermia (for a month or more) even in the absence of other symptoms warrants further or follow-up evaluation.
Treatment of blood in the semen is directed toward the underlying cause if a cause has been found. Sometimes, treatment with antibiotics for a presumptive diagnosis of prostatitis (inflammation of the prostate gland) is given, since some studies have shown that up to about one-fourth of men with hematospermia have prostatitis. However, the benefit of such treatment has not been definitively established.

Outlook for Haematospermia

The prognosis relates to the underlying cause of blood in the semen if a cause can be identified. However, most cases of hematospermia are benign and resolve without treatment. While cancer is a rare cause of blood in the semen, the majority of cases are not related to cancer, especially in younger men.


Complications
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Prevention
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