Hematospermia and Hematuria: Causes and Concerns

Hematospermia, Hematuria

Hello doctor, I used to masturbate almost once a day, and I have a habit of holding back ejaculation.
I experienced blood in my semen a few times, which recurred.
Recently, I went to see a doctor due to the blood in my semen, and after a urine test, it was determined that there was vascular damage.
I was given hemostatic medication, and after about two weeks, I recovered.
However, a month later, I experienced blood in my semen again, with the semen being completely blood-red.
I visited the doctor again, took antibiotics for a week, and continued with hemostatic medication for another week.
The semen turned dark red, and after a few days, it returned to a bloody color.
Additionally, I noticed blood in my urine when straining during bowel movements.

Could you please tell me if this is caused by inflammation or a ruptured blood vessel? The doctors have only mentioned vascular damage and have not indicated inflammation, but it has been almost two months, and I am still not recovered.
I am very concerned.
If the blood in my semen improves and then recurs, what could be the reason? Thank you, doctor.

J, 20~29 year old female. Ask Date: 2016/10/08

Dr. Sun Hongshun reply Urology

Hello, you have experienced recurrent hematuria or hematospermia multiple times, and it has persisted for several months.
This may require more than just a urinalysis; X-rays, ultrasound, or cystoscopy may also be necessary.
Please consult a trusted urologist.
Wishing you good health.

Reply Date: 2016/10/08

More Info

Hematospermia, or the presence of blood in semen, and hematuria, or blood in urine, can be concerning symptoms that warrant thorough investigation. Your situation, characterized by recurrent episodes of hematospermia and hematuria, raises several important considerations regarding potential underlying causes and necessary follow-up actions.

Understanding Hematospermia and Hematuria
1. Causes of Hematospermia:
- Infection: One of the most common causes of hematospermia is infection, particularly of the prostate (prostatitis) or seminal vesicles. Infections can lead to inflammation and damage to the blood vessels in these areas, resulting in blood being present in the semen.

- Trauma: Physical trauma to the genital area, whether from vigorous sexual activity, masturbation, or injury, can cause blood vessels to rupture, leading to hematospermia.

- Vascular Issues: Conditions that affect blood vessels, such as varicoceles or vascular malformations, can also lead to bleeding.

- Tumors: Although less common, tumors in the reproductive tract can cause bleeding. This includes benign conditions like cysts or more serious issues like malignancies.

- Systemic Conditions: Conditions that affect blood clotting or systemic diseases can also manifest as hematospermia.

2. Causes of Hematuria:
- Infection: Similar to hematospermia, urinary tract infections (UTIs) can lead to hematuria. Infections can irritate the bladder and urethra, causing bleeding.

- Kidney Stones: Stones in the urinary tract can cause irritation and bleeding, leading to hematuria.

- Trauma: Injury to the kidneys or bladder can result in blood in the urine.

- Tumors: Bladder or kidney tumors can also cause hematuria.

- Prostate Issues: Conditions affecting the prostate, including benign prostatic hyperplasia (BPH) or prostate cancer, can lead to blood in urine.

Your Symptoms and Concerns
Given your history of frequent masturbation and the subsequent episodes of blood in semen and urine, it is plausible that trauma or vascular injury could be contributing factors. The fact that you have experienced a recurrence of symptoms after a period of improvement suggests that there may be an underlying issue that has not been fully resolved.

1. Inflammation vs. Vascular Injury: While your doctor has indicated that blood vessel damage is a likely cause, it is essential to consider whether there is an inflammatory process at play. Inflammation can lead to increased vascular permeability, resulting in bleeding. If you have not yet undergone imaging studies (such as an ultrasound or MRI) or further diagnostic tests (like a cystoscopy), it may be prudent to discuss these options with your healthcare provider.

2. Follow-Up: Since you have been experiencing these symptoms for nearly two months without resolution, it is crucial to follow up with your healthcare provider. Persistent symptoms warrant further investigation to rule out any serious underlying conditions. This may include:
- Urinalysis and Semen Analysis: To check for signs of infection or other abnormalities.

- Imaging Studies: Ultrasound of the kidneys, bladder, and reproductive organs to identify any structural issues.

- Referral to a Specialist: A urologist can provide specialized care and may perform additional tests to determine the cause of your symptoms.

3. Lifestyle Considerations: While it is essential to address any medical issues, consider moderating activities that may contribute to trauma or irritation, such as excessive masturbation or vigorous sexual activity, until you have a clearer understanding of your condition.

Conclusion
In summary, hematospermia and hematuria can arise from various causes, including infections, trauma, and vascular issues. Given your recurrent symptoms, it is crucial to seek further evaluation to identify the underlying cause and receive appropriate treatment. Do not hesitate to communicate your concerns with your healthcare provider, as they can guide you through the necessary steps for diagnosis and management. Your health and peace of mind are paramount, and addressing these symptoms promptly is essential for your overall well-being.

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