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Bloody semen: A Nightmare for Gentlemen

Topic Hematospermia
FB Dr Soarawee
Soarawee Weerasopone, MD

Andrologist
Royal Phnom Penh hospital, Kingdom of Cambodia

Bloody semen or in medical term “Hematospermia” is the top one concerning between the others at my Andrology clinic. This kind of Andrological-related problem absolutely terrified the patient and their partner because they will see the fresh blood in semen with naked eyes. So, in this topic it will be cleared along with clarifying for all aspects about this terrified condition.

Hematospermia: Bloody semen - A Nightmare for Gentlemen
Blood in semen always terrified the suffered one.

Definition of Hematospermia

The definition of hematospermia is blood presenting in seminal fluid. The color visible as blood can be varied from a light red to brownish or even black clots. Mostly, it is painless. There was a report on the hematospermia prevalance approximately around 1 : 5,000 among urological patients.  Thoroughly, the medical advance knowledge nowadays, the etiology was also still unknown in over 70% of patients.

Brown colour
Sometimes it presents as brownish spot in semen.

Here are the possibly causes of hematospermia.

  1. Prolonged sexual abstinence
    • There was a classical literature reporting that more hematospermia problem found in male patients who was prolonging sexual abstinence because of his partner get pregnant.
    • Prolong abstinence time will leads to the situation of too much seminal vesicle distension resulting in minor bleeding at mucosal surface.
Prolong abstinence time
Not frequent ejaculation can lead to hematospermia.
  1. Trauma
    • History of urological procedures for examples; Transrectal ultrasound-guided biopsy or Cystoscopy.
    • History of unusual sexual practicing; intrarectal vibrator or intraurethral foreign body insertion.
    • History of perineal trauma.
Falling accident
A history of falling accident is essential.
  1. Infection
    • Prostate infection
    • Bladder infection
    • Urethral infection
  2. Organ-related causes
    • Seminal vesicle – obstruction or tumor
    • Prostate – polyps, calculi or tumor
    • Testis – tumor
    • Urethra – polyps, condylomas, strictures or tumor
  3. Systemic causes
    • Hypertension
    • Hematological conditions – Hemophilia
    • Coagulation disorders
    • Severe hepatic disease – Liver cirrhosis

In term of hematospermia management, urologist must seriously do with a good history taking, physical examination and a tailor-made investigation. Surprisingly, 40 years old is the magic number to categorize the hematospermia protocol. There was a confirmation of the literatures been told that, patients who under 40 years of age with no underlying disease can be managed as benign causes regardless of any aggressive investigation. On the other hand, if the investigations are pointing to or indicated then the tailor-made protocol will be fit for individuals.

Seriously history taking
Urologist must seriously do with a good history taking, physical examination and a tailor-made investigation.

Hematospermia problem can tremendously effect on patient’s psychology, so be better to understand the aspect of disease is necessarily. Any questions, you can discuss with your trusted andrologist, or it would be honor if you text me. See ya in next article!

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