Patient's question:
Hematospermia persists, abdominal pain for 2 weeks agoDoctor's answer:
Hello: Clinically, hematospermia is not uncommon. After detailed clinical and laboratory examinations, the majority can be controlled or cured through treatment, while only a very small number of tumor patients require further treatment. Since the composition of semen mainly comes from the seminal vesicles, with the prostate being the second source, and only a small volume consists of sperm, anatomically, the ejaculatory duct connecting the seminal vesicles opens at the urethral crest of the posterior urethra, surrounded by 10-20 openings of prostatic ducts. In fact, the seminal vesicles, the prostate, and the posterior urethra are interconnected, making it easy for inflammation to spread from one to the others. Additionally, the wall of the seminal vesicle is very thin, and once congested, the blood-filled wall is prone to bleeding. Therefore, the most common cause of hematospermia is seminal vesitis, followed by prostatitis, posterior urethritis, or posterior urethral congestion. It can also be caused by the spread of inflammation from nearby organs, leading to inflammation, swelling, congestion, and bleeding of the seminal vesicle wall. Generally, at least 70% of hematospermia cases in individuals under 30 are caused by inflammation. If hematospermia occurs only occasionally and no specific abnormalities are found upon examination, it may be due to minor blood vessel rupture and bleeding in certain tissues during sexual intercourse caused by sudden congestion and mechanical trauma. In such cases of transient hematospermia, there is no need to panic—cessation of sexual activity for one or two weeks can usually lead to complete recovery. Hemorrhage caused by inflammation tends to fluctuate but does not last long. If hematospermia persists and worsens progressively, the possibility of a tumor cannot be ruled out. Some patients may also have a generalized bleeding tendency in other parts of the body, which could indicate a systemic hemorrhagic disorder, such as leukemia or thrombocytopenia, rather than a localized condition. Other causes include tuberculosis, seminal vesicle cysts, seminal vesicle tumors, prostate cancer, portal hypertension due to liver cirrhosis, trauma, urinary tract obstruction, and benign prostatic hyperplasia, among others.