Hemospermia, or hematospermia - the appearance of blood in the ejaculate. Find out exactly the prevalence of this syndrome is impossible. Most of the episodes of hematospermia go unnoticed, since during unprotected intercourse, impurities in the semen are usually not noticed.
Fig. 1 - Sperm sample with signs of hemospermia.
The first manifestations of hematospermia may appear in a man of any age. Most often, the cause of hemospermia is non-specific inflammation of the prostate gland or seminal vesicles. But in rare cases, this condition can be the first manifestation of the malignant process of the urinary tract, in particular, prostate cancer (especially in men older than 65 years).
Hemospermia is false and true:
- in true hemospermia, blood is mixed with the ejaculate throughout the genital tract. Sperm often acquires a uniform brown color (see Fig. 1);
- with false hemospermia, the blood is mixed in the urethra, it looks fresh, often in the form of streaks.
If the episodes of hematospermia recur more than 10 times, it is called chronic.
Causes and mechanisms of occurrence
In about half of the cases, it is not possible to identify the cause of the appearance of this syndrome (idiopathic hemospermia). If the source of blood in the semen is detected, most often it happens:
Pathology of the prostate gland
- chronic prostatitis (up to a third of cases of hemospermia);
- calculi (stones) in the prostate, deferent duct, urinary tract;
- expansion of the prostatic uterus (blind pocket in the prostate gland);
- telangiectasia and varicose veins of the periprostatic plexus;
- malignant tumors of the prostate (cause hematospermia on average in 2% of cases).
Pathology of the urethra
- urethritis , especially in young men (7% of men with urethritis);
- polyps (in 20% of patients with polyps);
- condylomas (1.5%);
- strictures (contractions) of the urethra (1.5%).
Pathology of seminal vesicles
- cysts, both congenital and resulting from chronic inflammation;
- seminal vesicle carcinoma;
- amyloidosis seminal vesicles.
- herpes simplex virus;
- injuries of the testicles and perineum;
- foreign bodies in the urogenital tract;
- prostate biopsy - in this case, the blood in the ejaculate may appear within a month after the study. According to statistics, this happens in 9-45% of cases;
- TOUR - transurectal resection of the prostate.
- chronic liver failure;
- hemorrhagic diathesis;
- hypertension , especially severe, uncontrolled, accompanied by renal vascular disease;
- hyperuricemia (elevated levels of uric acid in the blood).
Examination is carried out in order to identify the cause of hemospermia. The older the patient, the more thorough it should be. If relatively young men (up to 50 years), as a rule, inflammation becomes the cause of hemospermia, and its detection is usually sufficient, then for older men an analysis of the level of prostate-specific antigen (prostate cancer marker) is mandatory. The main purpose of the survey is to eliminate life-threatening conditions, such as leukemia, cancer, and severe hypertension as quickly as possible.
To confirm the fact of hemospermia, a “contraceptive test” is used: ejaculation is performed on a condom.
To identify inflammatory processes in the urogenital system use:
- complete urinalysis;
- urine culture on microflora;
- seeding sperm on microflora;
- STD analysis (sexually transmitted diseases) ;
- transrectal prostate examination.
A blood test and a coagulogram will help to identify blood clotting disorders.
Transrectal ultrasound (TRUS) will help to accurately determine the state of the prostate and seminal vesicles. If it turns out to be uninformative, an MRI scan is needed to get more complete data.
The treatment of hemospermia is primarily in the treatment of the disease causing it. In the case of prostatitis or inflammation of other parts of the urogenital system, a course of antibiotics is needed (most often, fluoroquinolones are recommended for a course of at least 2 weeks). When detecting tuberculosis requires specific therapy.
Cysts are most often aspirated (removed) during puncture.
In identifying systemic diseases, it is necessary to engage in their treatment.
Despite the fact that hematospermia may be the first manifestation of such formidable conditions as cancer or leukemia, more often it does not pose a danger to the life and health of a man. Also, by itself, hemospermia cannot cause infertility, unless there are other disorders, such as azoospermia , teratozoospermia , asthenozoospermia.
Watch a video about hemospermia (hematospermia)