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Hematospermia is blood in semen. It is often frightening to patients but is almost always benign. Most cases are idiopathic. The most common known cause is prostate biopsy; other causes include benign prostatic hyperplasia, infections, disorders of the seminal vesicles, and tumors. The relative frequency and importance of each cause is unknown.
Urinalysis is required to check for infection. Semen inspection is necessary only when travel history suggests possible exposure to Schistosoma haematobium or S. mansoni. If patients are at risk of sexually transmitted infections, urethral cultures are indicated for Neisseria gonorrhoeae infection, chlamydia, and trichomoniasis. Prostate-specific antigen testing in elderly patients at risk of prostate cancer is controversial.
Treatment is directed at the cause if known. For almost all men, reassurance that hematospermia is not a sign of cancer and does not affect sexual function is the only intervention necessary.
Last full review/revision November 2005
Content last modified November 2005
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