Painless Urethral Bleeding: Causes and Concerns

Bleeding from the urethral opening without pain?

After sexual intercourse, I noticed blood in my pants, about 2CC.
I went to the hospital for examination, suspecting it might be a stone.
I underwent ultrasound, CT scan, and X-ray, but no stones were found.
About 15 days later, the bleeding decreased and stopped.
Then, my girlfriend performed oral sex and created a suction effect (similar to an octopus suction cup) for about 1 minute, which caused bleeding to start again, but it was only a small amount.
My girlfriend didn't believe it, so she suctioned again, resulting in bleeding that resembled the initial episode, with intermittent bleeding.
Sometimes there was no bleeding (there was blood before urination, but the urine itself was normal).
When I felt aroused (not fully erect, just a sensation), there was blood at the urethral opening, which was bright red.
Could this indicate a urethral injury or prostatitis? I initially thought the vacuum suction might have caused the bleeding.
I also tested ejaculation during masturbation, and the semen was normal, slightly yellow, and gel-like, with no blood.
I'm unsure how to recover.
What could be the issue?

Jian Dan, 40~49 year old female. Ask Date: 2020/05/28

Dr. Cai Zhuorong reply Urology

The possible causes of bleeding include stones, infections, trauma, etc.
It is recommended to undergo further examination.

Reply Date: 2020/05/28

More Info

Painless urethral bleeding can be a concerning symptom, especially when it occurs after sexual activity. Based on your description, it seems that you have experienced intermittent bleeding from the urethra, which has been associated with both sexual activity and oral stimulation. Given the investigations you've already undergone, including ultrasound, CT scans, and X-rays, which did not reveal any stones, it’s important to consider other potential causes.

One possibility is that the bleeding could be due to trauma or irritation of the urethra. The act of oral sex, especially if suction is applied, can create pressure that may lead to micro-tears in the delicate tissues of the urethra. This could explain why you noticed bleeding after your girlfriend used suction during oral sex. The fact that the bleeding is intermittent and occurs with certain activities suggests that it may be related to mechanical irritation rather than a systemic issue.

Another potential cause could be urethritis, which is inflammation of the urethra. This condition can be caused by infections, sexually transmitted infections (STIs), or irritation from chemicals or physical trauma. If there is any associated discomfort, burning during urination, or unusual discharge, it would be prudent to consider this possibility and consult a healthcare provider for further evaluation.

Prostatitis, or inflammation of the prostate gland, could also be a consideration, particularly if you experience pelvic pain or discomfort in the perineal area. However, prostatitis typically presents with additional symptoms such as pain during urination, difficulty urinating, or pain in the lower back or genital area.

Given that your urine appears normal and you have not noticed blood in your semen, it is less likely that there is a significant underlying issue with your prostate or seminal vesicles. However, if the bleeding persists or worsens, or if you develop new symptoms such as fever, chills, or severe pain, it is essential to seek medical attention promptly.

In terms of recovery, it is crucial to avoid any activities that may exacerbate the irritation or trauma to the urethra. This includes avoiding vigorous sexual activity until the bleeding resolves and you have consulted with a healthcare professional. They may recommend a urologist for a more specialized examination, which could include a cystoscopy to visualize the urethra and bladder directly.

In summary, while the intermittent painless urethral bleeding you are experiencing may be due to trauma from sexual activity, it is essential to monitor your symptoms closely. If the bleeding continues or if you have any concerns, please seek medical advice for a thorough evaluation and appropriate management.

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