Definition: Presence of blood in the semen known as haemato-spermia. It is often a frightening finding for patients. The incidence of hemato-spermia is difficult to quantify because most men do not observe their semen 

Most Important to Note: It is normally a Benign and Self Limiting condition.

  • Hemato-spermia is commonly benign and self-limited, especially in men younger than 40 years without risk factors and in men with no associated symptoms. 
  • These patients need minimal investigation, and they can be reassured if workup findings are negative, or treated if indicated. 

In Whom should there be a detailed assessment for haemato-spermia ?

  • Patients with risk factors or associated symptoms.
  • Patients 40 years and older
  • Persistent or recurrent haemato-spermia 

Etiology ?

  • Most Common 

             Prolonged sexual abstinence / Excessive masturbation

             Rigorous sexual intercourse 

  • Others

             Infectious ( 40%)

             Neoplastic (e.g., prostate cancer, testicular cancer), 

             Iatrogenic (e.g., prostate biopsy (most common]), prostate surgery, urologic instrumentation, radiation therapy, hemorrhoid injections) 

             Structural

             Systemic

             Vascular causes 

Assessment and Management Rules

  • History physical examination with emphasis on genital and digital rectal examination.
  • Rule out – hematuria / sex partner as source of blood. 
  • First / Self Limiting Episodes: Rule out infection, including STI
  • Age <40: Rule Out Testicular Cancer
  • Age > 40: Rule out Prostate cancer

Other points to be taken in to consideration are

constitutional symptoms / urinary symptoms and pain

. In presence of these further imaging is warranted. An

initial course of two weeks antibiotics may be given if infection suspected

along with something to massage the prostate from within.


Mostly it is a BENIGN condition, do not worry. Talk to your Urologist