Blood in Urine After Erection: Causes and Solutions - Urology

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Blood in urine, especially when associated with erections, can be concerning and warrants a thorough evaluation. Based on your description, it seems that you experience hematuria (blood in urine) specifically during episodes of erection, which is accompanied by the presence of blood clots but without pain. This symptom has been recurring for several years, occurring every few years, and has improved after a couple of weeks of abstaining from sexual activity.


Possible Causes
1. Microvascular Injury: As your previous doctor suggested, microvascular injury could be a potential cause. During an erection, increased blood flow and pressure in the pelvic region can lead to the rupture of small blood vessels, resulting in blood entering the urine. This could explain the intermittent nature of your symptoms, as the vessels may heal over time, leading to symptom resolution.

2. Urethral or Bladder Issues: Conditions affecting the urethra or bladder, such as inflammation or infection, could also lead to hematuria. However, the absence of pain during urination makes a urinary tract infection less likely.
3. Kidney Stones: While you mentioned the possibility of kidney stones, the fact that your symptoms are specifically linked to erections makes this less likely. However, stones can cause bleeding, especially if they irritate the urinary tract.
4. Prostate Issues: In men, prostate conditions, including benign prostatic hyperplasia (BPH) or prostatitis, can lead to hematuria. Although these conditions typically present with other symptoms, they can sometimes cause isolated bleeding.

5. Tumors: While less common, tumors in the urinary tract can cause hematuria. Given that you have had this symptom for years without significant changes, it is less likely, but it cannot be completely ruled out without further investigation.


Recommended Actions
1. Consult a Urologist: Given the nature of your symptoms, it would be prudent to consult a urologist. They specialize in urinary tract issues and can perform a thorough evaluation, including a physical examination, urinalysis, and possibly imaging studies or cystoscopy (a procedure to look inside the bladder and urethra).

2. Diagnostic Tests: The urologist may recommend tests such as:
- Urinalysis: To check for blood, infection, or other abnormalities.

- Imaging Studies: Such as an ultrasound or CT scan to visualize the kidneys, ureters, and bladder for stones or other abnormalities.

- Cystoscopy: To directly visualize the bladder and urethra, which can help identify any lesions or sources of bleeding.

3. Monitoring Symptoms: Keep a record of your symptoms, including the frequency of episodes, any associated activities (like sexual activity), and any other changes in your health. This information can be valuable for your healthcare provider.


Conclusion
While the symptoms you describe may be related to benign causes such as microvascular injury, it is essential to rule out more serious conditions. A urologist will be able to provide a comprehensive evaluation and guide you through the necessary steps to address your symptoms. Early diagnosis and management are crucial to prevent potential complications and ensure your overall urinary health.