Ejaculation with blood: What you need to know

The article is professionally consulted by MSc Vo Thien Ngon - Urologist, Department of General Surgery, Vinmec Danang International General Hospital.

Hematuria is a condition in which blood is present in the semen, due to many different causes. Most cases of blood in the ejaculate are caused by benign diseases, but there are some cases of bloody ejaculation that are a sign of malignancy, especially for people over 40 years old.

Normally semen is ivory white, when there is an abnormality, it can be seen that the sperm has red or pink blood, or the test shows that there is blood in the semen.
Sperm are produced in the testes and are nourished in the epididymis. During sex, the muscles contract and push the sperm out, on the way they receive more substances from the seminal vesicles and prostate gland before ejecting into the urethra.
Therefore, when a place on the spermatic tract bleeds, it causes blood in the ejaculate.
The causes of bloody ejaculation include:
Common causes: seminal vesicle inflammation, vasculitis, prostatitis, urethritis, epididymitis - testicular tuberculosis...; Varicose veins of the testicles; Obstruction of seminal vesicles, seminal vesicles or seminal vesicle stones; Injuries to urethra, pelvis, testicles...; Due to medical procedures such as prostate biopsy, prostatectomy, epididymectomy...; When the psychological relationship is too stressful or the position is not favorable, leading to damage to the urethral lining, it also causes blood in ejaculation; Systemic diseases: Coagulation disorders, hypertension, cirrhosis...; Due to the common malignancies in patients over 40 years of age with hematuria: Prostate cancer, testicular cancer, testicular cancer, lymphoma.

To diagnose the condition of blood in the ejaculate, it is necessary to rely on symptoms such as seeing red, pink, brown blood in the semen or testing red blood cells in the semen.
Determining the cause of blood in the ejaculate requires conducting the following paraclinical tests:
Abdominal ultrasound: Helps assess the status of prostate, liver, kidney, bladder; Testicular ultrasound: Helps to identify varicose veins of the testicles, epididymitis...; Transrectal ultrasound: It is an effective technique to diagnose diseases of the seminal vesicles and prostate such as prostate calcification, seminal vesicle stones, seminal vesicle dilatation, seminal vesicle cyst or ejaculatory duct cyst. ; Magnetic resonance imaging of the subframe: is the most valuable imaging technique in the exploration of seminal vesicles and prostate gland and is indicated in cases of suspected pathology on transrectal ultrasound. colon; Endoscopic seminal vesicles: Indicated to perform in the cases of bloody ejaculation lasting more than 3 months without finding any cause, or prolonged bloody ejaculation that detects abnormal seminal vesicles through ultrasound or imaging. Magnetic Resonance; Urinalysis: Helps evaluate urinary tract inflammation; Semen test: Do semen analysis, culture to find bacteria in semen, look for malignant cells in semen; Blood tests: Determination of blood count, erythrocyte sedimentation rate, blood clotting function status, PSA test (helps guide prostate cancer risk). However, not all patients do all of the above tests. The doctor will base on the disease status, disease duration, age and accompanying signs to orient the cause and give appropriate paraclinical indications, to help find the cause of the disease to conduct treatment. provide high efficiency.

Treatment of ejaculate blood needs to be based on the cause of the disease. The treatment methods for blood in the ejaculate include:
Medical treatment: In case of bacterial infection, use antibiotics according to the results of the antibiotic chart and in combination with anti-inflammatory drugs. Systemic causes using drugs to treat systemic diseases; Surgical treatment: Indicated in pathologies such as seminal vesicle obstruction, seminal vesicle cyst or seminal vesicle stone; urethral varicose veins; In early-stage cancers, surgery is also indicated. Ejaculation with blood can cause psychological anxiety in men, but most cases of hemorrhagic ejaculation are benign and can resolve on their own, but often recur. There are also some cases due to malignant causes. What should be done is to go to the doctor early to find the cause and timely treatment to help reduce treatment time, save costs and reduce recurrence.