Blood in Semen and Lower Abdominal Pain: A Urology Perspective

Q: Blood in Semen and Lower Abdominal Pain: A Urology Perspective

Hello： Regarding your issue, hematospermia is generally not uncommon and often resolves after a few occurrences. <br>However, I do not recall encountering patients with severe burning sensations in the right lower pelvis and right lower abdomen. <br>I strongly recommend that you

Small lump in the lower right abdomen with blood in semen?

Hello, around mid-November, I suddenly noticed a significant amount of blood in my semen during ejaculation.
I adjusted my daily routine and waited a few days to see if the blood would persist.
After about four days, I observed that the blood was dark brown and not as much.
Three days later, I noticed that only the last few ejaculations contained blood, so I thought the symptoms were improving and didn't pay much attention.
However, at the end of November, I found that the last few ejaculations still had a bit of blood, and I experienced intense cramping in my lower right abdomen during ejaculation.
A few hours later, I felt a severe burning sensation in my right lower pelvis and abdomen, which persisted whether I was sitting or lying down, gradually spreading from the area around my right pelvis to my lower right abdomen.
I also noticed a small lump in my lower right abdomen.
I adjusted my lifestyle again and made sure to stay active.
This symptom lasted for nine days before it began to decrease, but the lump gradually became slightly larger.
As of now, I still feel mild swelling and heat in my pelvis, but it is not as intense as it was initially.
Additionally, I have refrained from masturbation for over a month due to fear of blood reappearing.
Recently, as my body felt somewhat recovered, I noticed that when I experience sexual arousal, the lump in my lower right abdomen becomes increasingly prominent and warm, but it gradually subsides when I am not aroused.
However, the lump still does not disappear, and when lying down, I can distinctly feel a round, gas-like mass.
This has significantly decreased my libido.
I would like to know if these persistent symptoms could potentially lead to further blood in my semen or the aforementioned burning and cramping sensations?

You, 20~29 year old female. Ask Date: 2017/12/25

Dr. Du Shixi reply Urology

Hello: Regarding your issue, hematospermia is generally not uncommon and often resolves after a few occurrences.
However, I do not recall encountering patients with severe burning sensations in the right lower pelvis and right lower abdomen.
I strongly recommend that you visit a urology department at a hospital, especially concerning the mass in your right lower abdomen.
Wishing you good health.

Reply Date: 2017/12/25

More Info

It sounds like you are experiencing a concerning set of symptoms, including blood in your semen (hematospermia), lower abdominal pain, and a palpable mass in your right lower abdomen. These symptoms warrant a thorough evaluation by a healthcare professional, particularly a urologist, as they can indicate various underlying conditions.

Understanding Hematospermia and Associated Symptoms
Hematospermia can arise from several causes, including infections, inflammation, trauma, or even benign conditions such as cysts or varicoceles. In your case, the presence of blood in your semen, especially if it is accompanied by pain and a palpable mass, suggests that there may be an underlying issue that needs to be addressed.

1. Possible Causes:
- Infection: Prostatitis (inflammation of the prostate gland) or epididymitis (inflammation of the epididymis) can lead to both hematospermia and pain. These conditions can be caused by bacterial infections and may require antibiotic treatment.

- Trauma: Any recent trauma to the pelvic area could lead to bleeding and subsequent hematospermia.

- Cysts or Tumors: The palpable mass you describe could be a cyst or a more serious condition, such as a tumor. This needs to be evaluated through imaging studies, such as an ultrasound or CT scan.

- Vascular Issues: Conditions like varicoceles (enlarged veins within the scrotum) can also cause discomfort and may be associated with hematospermia.

2. Symptoms to Monitor:
- The burning sensation and the heat you feel in your lower abdomen, especially if it is persistent, should not be ignored. This could indicate inflammation or infection that may require immediate attention.

- The size and consistency of the mass you feel in your abdomen should be monitored. If it continues to grow or changes in character, it is crucial to seek medical advice.

3. Recommended Actions:
- Consult a Urologist: Given the complexity of your symptoms, a urologist can perform a thorough examination, including a digital rectal exam, and may recommend tests such as urinalysis, semen analysis, and imaging studies to determine the cause of your symptoms.

- Avoid Sexual Activity: Until you have been evaluated, it may be wise to refrain from sexual activity to prevent exacerbating any potential underlying condition.

- Pain Management: Over-the-counter pain relievers such as ibuprofen or acetaminophen may help manage discomfort, but they do not address the underlying issue.

4. Potential Complications:
- If left untreated, conditions like prostatitis or epididymitis can lead to complications, including chronic pain or fertility issues. Therefore, it is essential to address these symptoms promptly.

In conclusion, while some cases of hematospermia may resolve on their own, the combination of blood in your semen, persistent abdominal pain, and a palpable mass necessitates a thorough medical evaluation. Early diagnosis and treatment can help prevent complications and improve your overall health. Please seek medical attention as soon as possible to address these concerning symptoms.

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