weird and wacky Flashcards
What is haematospermia?
Presence of blood in semen
What can cause of haematospermia?
- STI
- UTI
- Trauma
- Prostate procedures
- Bleeding disorders
- Sickle cell
- Haematological malignancy
- Uncontrolled hypertension
- Prostatitis
- BPH
- Abnormal prostate vessels
- Vesicle/ejac duct disease
- Tropical infections
- TB
- Cancer
- Prolonged abstinence
Symptoms to consider when evaluating haematospermia?
Timing, frequency, duration, amount, and colour of bleeding
Urinary symptoms
STI symptoms
pain on ejaculation (prostatitis / ejaculatory duct obstruction
general health
What additional health history should be reviewed for haematospermia?
PMH
bleeding disorders
Urological problems / ED / BPH
Chronic liver disease
drug history anticoagulants/antiplatelets
Family history prostate cancer at a young age
Travel history - Africa
Sexual history
Examination recommended for haematospermia?
- Genital exam
- DRE prostate
- Abdominal examination, Check for hepatosplenomegaly, Kidney examination
- Blood pressure
What initial investigations should be considered for patients with haematospermia?
- FBC
- Clotting tests
- U+E / LFT
- MSU
- STI screen
- Consider KUB USS/testes USS depending on symptoms
Haemato spermia in patients under 40 years is often self-limiting, and infections are common.
What additional test is recommended for patients over 40 years with haematospermia?
- PSA
What is the management for a one-off case of haematospermia for men <40?
Reassurance
If a single episode of haematospermia and no underlying cause has been identified on initial assessments and investigations.**
Most one-off cases do not indicate serious underlying issues.
What should be done if a patient under 40 years has 10 or more episodes of haematospermia?
Refer to urology
Referral to urology for men and boys of all ages who have recurrent or persistent haematospermia or ongoing haematospermia despite treatment of a suspected underlying cause identified in primary care
What is the recommended management for patients over 40 years with haematospermia?
Refer to urology
Patients in this age group are at higher risk for serious conditions such as cancer.
