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The article is expertly consulted by Master, Doctor Le Phuc Lien - Urologist - Department of General Surgery - Vinmec Nha Trang International General Hospital. The doctor has more than 12 years of experience in the field of urology and specialized urology.Normal semen is ivory white. If the semen turns pink or red, it is suspected that there is blood in the semen. This condition is sometimes harmless and goes away on its own without any treatment. However, bloody ejaculation can also be a warning sign for many other underlying medical conditions.
1. What is blood in the ejaculate?
Semen is a product of the male reproductive system. Semen is produced from multiple organs, including the testes, epididymis, vas deferens, seminal vesicles, and prostate gland.
The presence of blood during ejaculation is called bloody semen (“haematospermia”). It is usually a painless, benign, solitary, and self-limiting symptom.
Blood in the semen is not uncommon, and can affect any man of any age after puberty. The disease is benign and self-limited, but it often recurs. However, the most common age group affected are men between the ages of 30 and 40. According to epidemiological statistics, up to 9 out of 10 men have ever encountered bloody semen without any previous symptoms or abnormal urinary or genitourinary condition.
2. Symptoms of bloody ejaculation
Blood in the semen usually does not cause pain, but the patient can only see blood in the semen. Blood causes semen to change color from dark brown to bright red. In addition, the patient may have no other symptoms. However, in cases of secondary bleeding, the patient may have additional symptoms such as pain during ejaculation or a dull pain in the area from the testicle to the perineum. These are considered signs of prostate diseases such as prostatitis. At this time, if the patient has the following factors that need to be investigated more carefully:
Age over 40 years old; Persistent or repeated symptoms; Abnormalities are detected on examination of the urogenital system; There are comorbidities in other organs.
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3. Causes of bloody ejaculation
Causes of blood in ejaculation are divided into two main groups:
3.1. Primary hematuria In this case, the presence of blood in the semen is the only symptom.
In addition, the possibility of blood in the urine should also be excluded, either at the macroscopic or microscopic level. At the same time, the patient was also examined and there was absolutely no evidence of any abnormalities in the structure or function of the urinary system in general. Fortunately, the condition is self-limiting and leaves no sequelae.
In fact, patients with primary hematuria have been studied extensively and most of these studies show no other associated problems.
3.2. Secondary hematuria The cause of bleeding in the semen is known or suspected to have a pre-existing origin, such as shortly after a prostate biopsy, urinary tract infection, or cancer.
The following is a list of common causes:
Inflammation and infection:
Inflammation is one of the most common causes. The inflammatory process causes mucosal irritation leading to congestion and edema of the ducts, glands of the seminal vesicles, seminal vesicles, prostate gland, mounds and urethra. This causes blood in the ejaculate.
Inflammatory agents are caused by infection, trauma, seminal vesicle stones, or prostate calcification. Common bacterial infections such as: Enterobacteria (mainly Escherichia coli), Chlamydia, Gram-positive, tuberculosis bacilli and some viruses.
Obstruction of seminal vesicles and seminal vesicles:
Causes of stretching and dilatation of seminal vesicles for a long time will cause rupture of submucosal blood vessels.
Cancer:
Common types of cancer include prostate cancer, testicular cancer, testicular cancer, lymphoma.
Diseases affecting the whole body:
Common systemic diseases are coagulation disorders, hemophilia, cirrhosis, hypertension.
Due to local invasive procedures:
Transrectal prostate biopsy, urethral instrumentation, irradiation in prostate cancer, after vasectomy, after orchiectomy,...
Varicose veins of the urethra:
In this case, there is usually no blood in the semen, but the patient finds a lot of blood in the urine after an erection, or bleeding out of the urethra after an erection without ejaculating.
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4. Approach to diagnosis when having blood in the ejaculate
Anytime blood in semen is detected, men should see a doctor for a local as well as general examination. The doctor will examine the external genitalia as well as the prostate gland to detect potential problems.
Besides, the doctor may order other tests, including:
Urinalysis to check for infection; Quantitative PSA blood test to screen for prostate cancer; Microbiological tests for the diagnosis of sexually transmitted infections; Ultrasound examination of the groin area and urinary tract, transrectal ultrasound; In addition, you can be performed more specialized laboratory tests to find the cause of the disease such as computed tomography, magnetic resonance imaging or urethroscopy - cystoscopy, seminal vesicle endoscopy...
5. How to treat ejaculate with blood?
In general, hematuria sometimes does not require any treatment as the condition usually resolves on its own. This is often true for cases of primary hematuria, ie, the cause is unknown.
In contrast, patients over 40 years of age with persistent hematuria, especially with other symptoms, should be referred to a urologist. Then, the problem of treatment will depend on the cause of the disease:
Bacterial infections caused by common bacteria: Use antibiotics, anti-inflammatory and oral hemostatic drugs. Genitourinary - urological TB: Treatment according to the TB treatment regimen. The surgical treatment depends on each specific case with indications for open surgery or laparoscopic transurethral or laparoscopically in the case of occlusion of the seminal vesicles, seminal cysts or seminal vesicle stones; prostate cancer, cancer of the testicles and testicles, varicose veins of the urethra... In short, blood in the ejaculate sounds scary, but most of them go away on their own. However, do not be subjective. Instead, men need to actively visit a male specialist, actively monitor and adhere to treatment to eliminate potential diseases as well as relieve anxiety, confidently enjoy happiness. life.
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