haematospermia

Question 1

Haematospermia causes:

Answer 1

Infection:

• chlamydia, gonorrhoea, TB
• viral HIV, herpes, CMV
• Shcistosomiasis

Iatrogenic e.g. post vasectomy, post orchidectomy

Malignancy
-prostate, bladder, testicular, Urethral

Trauma
- post coital

Obstruction

• cysts of seminal vescicles
• calculi e.g. prostate

Systemic

• HTN
• chronic liver disease
• Lypmhoma
• Leukaemia
• Bleeding disorders

(RACGP 2015: Haematospermia)

Question 2

Investigations

Answer 2

fbc, coagulation studies
urine mcs
urine for cytology
psa if > than 40 or DRE abnormal, risk factors present

If TB suspected –> urine and semen acid fast bacilli
Parasites

Question 3

Red Flags

Answer 3

• Men ≥40 years of age
• Persistent or recurrent haematospermia • Suspicious DRE  ndings
• Abnormal PSA results
• Suspicion of prostate, bladder, testicular
or urethral malignancy on history,
examination or investigations
• Concurrent haematuria
• Haematospermia despite treatment for
suspected cause