Hematospermia
Hematospermia is the presence of blood in the ejaculate. It is most often a benign symptom. Among men age 40 or older, hematospermia is a slight predictor of cancer, typically prostate cancer. No specific cause is found in up to 70% of cases.
Cause
Though haematospermia may cause considerable distress to patients, it is often a benign and self-limiting condition caused by infections, particularly in younger patients. An isolated episode is usually considered benign and not likely to be associated with malignancy. Recurrent haematospermia may indicate a more serious underlying pathology particularly in patients over 40 years of age.Infection and inflammation
Infection or inflammation is considered the most common cause of the condition. Implicated pathogens include; Gram-negative bacteria, gonococci, Treponema pallidum, Chlamydia trachomatis, Neisseria gonorrhoeae, echinococcus, HSV type 1 or 2, and HPV. The condition may also rarely be caused by some chronic systemic infections like tuberculosis or schistosomiasis. Additionally, testicular, prostate, and epididymal inflammation in general may present with haematospermia as feature.Neoplasm
Some neoplasms of the genitourinary system may present with haematospermia. Malignant causes of haematospermia include; prostate cancer, testicular or epididymal tumours, seminal vesicle carcinoma, and urethral tumour. Lymphomas and leukaemias may also feature haematospermia as symptom.Prostate
Various prostate pathologies may result in blood occurring in the ejaculate.Other
Systemic conditions like malignant hypertension, liver dysfunction, or bleeding disorders, and amyloidosis may sometimes be present with hematospermia as symptom. Trauma to the region may also cause the condition. Additionally, structural anomalies of genitourinary anatomy may result in hematospermia as symptom.Excessive sex or masturbation, prolonged sexual abstinence, interrupted sex, and certain sexual behaviours may also result in hematospermia.