Post-Ejaculation Hematuria: Treatment and Precautions

Regarding the follow-up treatment and precautions for hematospermia?

Hello, Doctor Lin.
I experienced hematospermia in 2012 and saw a doctor who prescribed anti-inflammatory medication for treatment, but I did not undergo further examination.
After finishing the medication, the issue resolved.
However, about a week ago, after having sexual intercourse, I experienced hematospermia again, which appeared entirely pink, not just streaks or clots, similar to 2012.
This time, the doctor prescribed antibiotics for a month and recommended a semen analysis afterward.

If we consider the possibility of a prostate infection, should I avoid sexual intercourse during this period? Or is it strongly advised to use condoms? Is there a risk to my partner or myself if I do not use protection? Can I engage in oral sex? Additionally, during the sexual encounter that led to the hematospermia, I tried to prolong the experience by stopping thrusting multiple times before ejaculation.
Towards the end, my penis felt very swollen, almost like it was going to burst.
Could the hematospermia be caused by a rupture of blood vessels due to this?

Niming, 20~29 year old female. Ask Date: 2015/03/09

Dr. Li Xinyi reply Urology

Doctor, if we consider prostatitis as a premise, should sexual intercourse be avoided during this period? Or is it strongly recommended to always use condoms? Is there a risk to the female partner or to myself if condoms are not used? Is oral sex permissible?
ANS: Generally, it is acceptable.
However, if you engage in high-risk sexual behavior, that is a different matter.
Additionally, during the sexual activity that resulted in hematospermia, I tried to prolong the experience by stopping repeatedly when I was close to ejaculation.
In the end, my penis felt very swollen, almost like it was going to burst.
Could the hematospermia be caused by this practice leading to a rupture of blood vessels?
ANS: This is improper use.
It is possible that it could cause hematospermia.

Reply Date: 2015/03/09

More Info

Post-ejaculation hematuria, or the presence of blood in semen after ejaculation, can be concerning and may indicate underlying health issues. Given your history of similar symptoms in 2012, it is wise to approach this situation with caution and seek medical advice, as you have done.

Understanding Post-Ejaculation Hematuria
Hematuria can arise from various causes, including infections, inflammation, or trauma to the reproductive or urinary systems. In your case, the recurrence of pinkish semen after sexual activity suggests a possible infection, such as prostatitis (inflammation of the prostate gland), which is often associated with symptoms like pain, difficulty urinating, or discomfort during ejaculation.

Treatment and Precautions
1. Antibiotic Treatment: Since your doctor has prescribed antibiotics, it is crucial to complete the entire course as directed. This will help address any bacterial infection that may be contributing to your symptoms.

2. Follow-Up Testing: The recommendation for a semen analysis is important. This test can help identify any abnormalities in the semen, such as the presence of white blood cells, which may indicate infection or inflammation.

3. Avoiding Sexual Activity: While undergoing treatment for a suspected prostate infection, it is generally advisable to avoid sexual intercourse. This is to prevent further irritation or potential injury to the prostate and to reduce the risk of transmitting any infection to your partner. Using condoms can provide a barrier that may help protect both you and your partner from potential infections, especially if there is any uncertainty regarding the cause of the hematuria.

4. Oral Sex Considerations: Engaging in oral sex while experiencing symptoms of a potential infection should be approached with caution. If you have an active infection, there is a risk of transmitting bacteria to your partner. It is best to consult your healthcare provider for personalized advice based on your specific situation.

5. Physical Activity and Ejaculation Techniques: The technique you described—stopping just before ejaculation—can sometimes lead to increased pressure in the blood vessels of the penis, potentially causing minor trauma or rupture of small blood vessels. This could contribute to the presence of blood in the semen. It may be beneficial to discuss your sexual practices with your healthcare provider to ensure they are not contributing to your symptoms.

Conclusion
In summary, post-ejaculation hematuria can be a sign of underlying issues that require attention. Your proactive approach in seeking medical advice and following through with treatment is commendable. It is essential to adhere to your doctor's recommendations, including completing the antibiotic course and undergoing further testing. Avoiding sexual activity during this time is advisable to prevent complications and ensure proper healing.

If symptoms persist or worsen, or if you experience additional symptoms such as pain, fever, or changes in urination, it is crucial to return to your healthcare provider for further evaluation. Open communication with your doctor about your symptoms and concerns will help guide your treatment and ensure the best possible outcome.

Similar Q&A

Understanding Post-Ejaculation Bleeding: Causes and Concerns

Well... I'll be honest! After my last ejaculation, it turned out to be blood instead of semen. A week later, I thought I would try again... and the result was the same = =" What is going on? 0.0!!

Dr. Lin Yisheng reply Urology
Basically, it is important to differentiate between hematuria (blood in urine) and hematospermia (blood in semen). Possible causes include trauma, inflammation, infection, or tumors, with some cases remaining idiopathic. In young individuals, it is often self-limiting and general...

Understanding Hematuria and Hematospermia: Causes and Solutions

Hello Dr. Hsu: At the age of 20, I experienced symptoms of hematospermia, which have recurred over the past six years. In the last two years, I have had hematospermia accompanied by hematuria. The day after hematospermia, I noticed blood in the second urine sample, usually with s...

Dr. Xu Weikai reply Urology
A-Hai: Hello, it's difficult to make a judgment. It could be due to a ruptured blood vessel that hasn't healed, which may worsen the condition with continued ejaculation and erection. Note: If there is bleeding during ejaculation and clinical assessment indicates it...

Post-Surgery Hematospermia and Hematuria: Understanding Causes and Recovery

Several years ago, I experienced hematospermia of unknown origin, which resolved after receiving treatment at a clinic (semen analysis showed no issues). Recently, I noticed the presence of blood in my semen again, accompanied by significant hematuria (resembling tomato juice). I...

Dr. Du Shixi reply Urology
Hello: May I ask if the issue is due to the surgical wound not fully healing, or is it because blood in the seminal vesicles has not been expelled? -- If the blood is bright red, it indicates fresh bleeding; if it is dark, it is more likely old blood or could potentially be due t...

Understanding Hematuria: Questions on Treatment and Recovery

Hello Doctor, I am the person who inquired about hematuria a few days ago. After following your advice, I visited a urology clinic and underwent relevant urine and blood tests. The doctor prescribed hemostatic and analgesic medications and advised me to wait for the report next w...

Dr. Du Shixi reply Urology
Hello: If there is no bleeding, there is no need to take hemostatic medication; taking it will not have a therapeutic effect, and the side effects should be minimal (please refer to the medication packaging). As for if there is still bleeding, there should be symptoms, but there ...