Blood in Urine and Semen: When to Seek Urology Help

Hematuria followed by hematospermia two days later?

On the night of September 27th, after being intimate with my girlfriend, I forgot to remove the condom and fell asleep.
In the morning, we were intimate again, and when I went to urinate, I noticed red urine with many dark red clots.
I then drank a lot of water, and my second urination was normal.
However, I felt a slight aching sensation below my navel, around the area of the prostate.
Two days later, feeling anxious, I decided to check if my semen was also red, and it turned out to be mixed with red.
I immediately went to the emergency room.
The emergency doctor performed an X-ray and a urinalysis, both of which showed no issues.
They prescribed me a hemostatic medication (Trand 250mg Cap) and a urinary tract medication (Uroprin 100mg Tab).
After taking them, my urine turned orange-red, which I found very alarming.
Today, October 2nd, I stopped taking the medication.
Is there something wrong with my testicles? I have a day off on Monday (October 5th) and plan to visit the urology department again; is that too late?

Jiong, 20~29 year old female. Ask Date: 2015/10/02

Dr. Xu Weikai reply Urology

Hello, it is normal for your urine to turn orange-red after taking this medication.
Please wait for the examination results.
If you have any further questions, feel free to ask, and we can discuss and research together.
Information from the internet should only be used as a reference; if necessary, you should visit a medical institution for treatment.
The Ministry of Health and Welfare Taitung Hospital cares about you.

Reply Date: 2015/10/02

More Info

When it comes to the presence of blood in urine (hematuria) and semen (hematospermia), it is crucial to understand the potential underlying causes and when to seek medical attention. Your recent experiences of noticing red urine with dark red clots and red-tinged semen can be alarming and warrant a thorough evaluation by a urologist.

Understanding Hematuria and Hematospermia
Hematuria can be categorized into two types: gross hematuria, where blood is visible to the naked eye, and microscopic hematuria, which is only detectable through laboratory testing. Possible causes of hematuria include urinary tract infections (UTIs), kidney stones, trauma, tumors, or benign conditions such as benign prostatic hyperplasia (BPH) in men.
Hematospermia, on the other hand, refers to the presence of blood in semen. This condition can arise from various sources, including infections, inflammation of the prostate (prostatitis), or trauma. While hematospermia is often benign, it can sometimes indicate more serious conditions, such as prostate cancer or other malignancies.

Your Symptoms and Initial Evaluation
Based on your description, you experienced:
1. Red urine with dark red clots: This could indicate bleeding from the urinary tract, possibly from the bladder or urethra.

2. Red-tinged semen: This suggests bleeding from the reproductive tract, potentially from the prostate or seminal vesicles.

3. Pain in the lower abdomen: This could be related to inflammation or irritation in the pelvic region, possibly involving the prostate.

You mentioned that after visiting the emergency department, tests such as X-rays and urinalysis did not reveal any significant issues, and you were prescribed medications. However, the change in urine color to orange after taking the medication could be due to the dye in the medication or a reaction to the treatment.

When to Seek Further Medical Help
Given your symptoms and the fact that you are still experiencing discomfort, it is advisable to follow up with a urologist as soon as possible. Here are some reasons why:
1. Persistent Symptoms: If you continue to experience blood in your urine or semen, or if the pain persists, further evaluation is necessary.
2. Diagnostic Tests: A urologist may recommend additional tests, such as a cystoscopy (to visualize the bladder), ultrasound, or MRI, to identify any underlying issues that were not detected in the initial evaluation.

3. Potential Complications: Delaying further evaluation could lead to complications if there is an underlying condition that requires treatment.

Conclusion
In summary, while some cases of hematuria and hematospermia can resolve on their own, your symptoms suggest that a thorough evaluation is warranted. It is essential to communicate all your symptoms clearly to your healthcare provider, including the timing, severity, and any associated discomfort. Given that you have already experienced alarming symptoms, it is prudent to prioritize your health and seek a urology consultation without delay. Early diagnosis and treatment can significantly improve outcomes and alleviate any potential complications.

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