What causes hematospermia?

Hematospermia may be caused by seminal vesiculitis, prostatitis, urethral injury, reproductive system tuberculosis, seminal vesicle tumors, etc. It usually presents with symptoms such as blood in the semen, painful ejaculation, and perineal swelling and pain. It is recommended to seek medical examination promptly and provide targeted treatment after the cause is determined.

1. Seminal vesiculitis

Seminal vesiculitis is the most common cause of hematospermia, mostly caused by bacterial retrograde infection. In addition to pink or dark red semen, patients are often accompanied by a feeling of bloating in the lower abdomen. Fever may occur in the acute phase and may recur in the chronic phase. Antibiotic treatments such as levofloxacin tablets and cefixime dispersible tablets are commonly used in clinical practice, combined with warm water sitz baths to relieve symptoms.

2. Prostatitis

When the prostate is congested and edematous, it may cause capillaries to rupture, causing semen to mix into the blood. Such patients are often accompanied by urinary abnormalities such as frequent urination and urgency, and the enlarged prostate can be palpable on digital rectal examination. For treatment, tamsulosin hydrochloride sustained-release capsules can be used to improve urination, combined with Qianlieshutong capsules and other Chinese patent medicines for conditioning.

3. Urethral injury

Excessive sexual intercourse or urethral instrumentation may cause mucosal damage, and blood mixed with semen usually appears bright red. In most cases, the injury can heal on its own. In severe cases, tranexamic acid tablets are required to stop bleeding, and urethral suturing is performed if necessary. It is recommended to suspend sexual activity during treatment.

4. Reproductive system tuberculosis

When Mycobacterium tuberculosis infects the seminal vesicles or prostate, it can cause tissue necrosis and bleeding. Patients often have typical symptoms of tuberculosis such as low-grade fever and night sweats, and acid-fast bacilli can be seen in semen examination. Anti-tuberculosis drugs such as isoniazid tablets and rifampicin capsules need to be used in combination for a long time, and the course of treatment usually takes 6-9 months.

5. Seminal vesicle tumors

Seminal vesicle cysts or malignant tumors may erode blood vessels and cause bleeding. This type of hematospermia often persists and gradually worsens. The diagnosis can be confirmed by transrectal ultrasound or MRI. Benign tumors can be treated with seminal vesiculoscopic surgery, while malignant tumors require radical resection or radiotherapy and chemotherapy according to the stage.

If hematospermia occurs, strenuous exercise and long-term cycling should be avoided to reduce pelvic congestion. Eat a light diet, eat more vegetables and fruits rich in vitamin C such as broccoli and tomatoes, and limit spicy and irritating foods. Maintain a regular frequency of ejaculation, neither abstinence nor excessiveness. During the treatment period, it is recommended to review the semen routine every 2-3 months to observe the treatment effect. If hematospermia persists for more than 1 month or is accompanied by systemic symptoms such as weight loss, tumor screening needs to be performed immediately.