Hematospermia After Epididymitis Treatment: Causes and Next Steps

Q: Hematospermia After Epididymitis Treatment: Causes and Next Steps

Hello： 1. <br>Is there a correlation between seeing a doctor and epididymitis? --> The correlation is likely minimal. <br>2. <br>Is a follow-up appointment necessary for further management? --> If there is persistent hematospermia, a follow-up with a urologist is recommended. <br

After treatment for epididymitis, the patient experiences hematospermia?

Hello Doctor: I previously inquired about an epididymal issue (details in #177311 regarding unprotected sexual activity).
On January 10, I consulted my attending physician again about the epididymitis (which is no longer painful and has reduced swelling, leaving only a hard lump).
The attending physician indicated that I could continue taking the same medication for another week and that there was no need for further urinalysis or follow-up visits.
However, after stopping the medication on January 12, I noticed blood in my semen on January 13, which persisted until January 16.
Notably, there was no blood in my semen during the first week of epididymitis, and there was no sexual activity between the resolution of the epididymitis and the onset of the hematospermia.
Currently, I do not have any unusual symptoms during ejaculation or in my urinary tract, aside from the hard lump in the epididymis and the presence of blood in my semen.

1.
Could this be related to the epididymitis?
2.
Is a follow-up appointment necessary for further evaluation?
3.
After taking medication for 10 consecutive days, is it possible that there is still a urinary tract infection causing the hematospermia?
I would appreciate any relevant advice.
Thank you! Below are the urinalysis results from January 3:
Urine (midstream)
No growth to date
Appearance: Yellow - Clear
Bacteria (sediment): Negative
Bili (U/A): Negative (-)
Cast (sediment): None
Crystal (sediment): None
Epithelium cell (sediment): 0-5 /HPF
Glu (urine): Negative (-)
Ketone (U/A): Negative (-)
Leucocyte esterase: +/-
Nitrite (U/A): Negative (-)
OB (urine): Negative (-)
Protein (urine): Negative (-)
RBC (sediment): 0-2 /HPF
SG: 1.005
Urobilinogen (U/A): 0.2
WBC (sediment): 0-5 /HPF
pH: 7.5

m, 20~29 year old female. Ask Date: 2022/01/17

Dr. Du Shixi reply Urology

Hello: 1.
Is there a correlation between seeing a doctor and epididymitis? --> The correlation is likely minimal.
2.
Is a follow-up appointment necessary for further management? --> If there is persistent hematospermia, a follow-up with a urologist is recommended.
3.
After taking medication for 10 consecutive days, is it possible that a urinary tract infection is still causing hematospermia? --> The likelihood is low.
Wishing you good health.
You can refer to http://www.tand.org.tw/publications/into.asp?/332.html.

Reply Date: 2022/01/17

More Info

Hematospermia, or the presence of blood in semen, can be a concerning symptom for many men, especially following a condition like epididymitis. Understanding the potential causes and the next steps to take is crucial for effective management.

Causes of Hematospermia After Epididymitis Treatment
1. Residual Inflammation: After an episode of epididymitis, inflammation can persist in the reproductive tract, including the epididymis and surrounding structures. This inflammation may lead to blood vessels becoming more fragile, resulting in bleeding during ejaculation.

2. Infection: Although your urine tests showed no growth and were largely negative for signs of infection, it is still possible that a low-grade infection could be present in the reproductive tract that was not detected. This could lead to hematospermia.

3. Trauma or Injury: If there was any trauma to the genital area, even minor, it could cause bleeding. This is particularly relevant if there was any recent sexual activity or vigorous physical activity.

4. Vascular Issues: Conditions affecting blood vessels, such as varicoceles or other vascular malformations, can also lead to hematospermia.
5. Prostate Issues: Conditions affecting the prostate, such as prostatitis or benign prostatic hyperplasia (BPH), can also lead to blood in the semen.

Next Steps
1. Follow-Up Appointment: It is advisable to schedule a follow-up appointment with your urologist. Given that you have experienced hematospermia after a recent episode of epididymitis, further evaluation is warranted to rule out any complications or persistent infections.

2. Diagnostic Tests: Your doctor may recommend additional tests, such as a transrectal ultrasound or a prostate exam, to assess for any underlying issues that could be contributing to the hematospermia.

3. Monitoring Symptoms: Keep track of any additional symptoms you may experience, such as pain during ejaculation, changes in urination, or any other unusual signs. This information can be helpful for your healthcare provider.

4. Avoid Sexual Activity: Until you have been evaluated, it may be wise to avoid sexual activity to prevent any potential exacerbation of the condition.

5. Hydration and Rest: Ensure you are well-hydrated and allow your body to rest as it recovers from the previous infection.

Conclusion
While hematospermia can be alarming, it is often benign and resolves with time, especially following an infection like epididymitis. However, it is essential to consult with your healthcare provider to ensure that there are no underlying issues that need to be addressed. Early intervention can help prevent complications and ensure a swift recovery. If the hematospermia persists or is accompanied by other concerning symptoms, do not hesitate to seek medical attention promptly.

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