Haematospermia

Haematospermia is the presence of blood in the semen. This condition can be very worrying and quite a shock but is generally benign and self-limiting. However, it can sometimes indicate underlying medical issues.

While haematospermia itself does not directly cause male infertility, it can be associated with underlying conditions that may affect fertility. Some of these conditions include:

1. Infections and Inflammation: Chronic infections and inflammation can impair sperm function and production, leading to reduced fertility.
2. Obstructions: Blockages in the reproductive tract can prevent the passage of sperm, leading to issues with sperm delivery. A very important symptom to look out for is a change in the volume of semen you ejaculate.
3. Trauma: Injuries that cause haematospermia can also damage the reproductive organs, potentially affecting sperm production or function.
4. Cancer and tumours: Malignant conditions such as prostate cancer affecting the reproductive organs can interfere with sperm production or delivery.

Diagnosis and Treatment

The evaluation of haematospermia typically includes:

1. Medical History and Physical Examination: Dr Sangster aims to identify potential causes and associated symptoms. A digital rectal examination of the prostate may be needed.
2. Urinalysis, culture and semen analysis: To check for infections or abnormalities. This is also vital in checking the volume of ejaculate.
3. Imaging Studies: Ultrasound of the testicle and prostate are often utilised. Occasionally a pelvic MRI may also be used. 
4. Blood Tests: To check for infections, inflammation, tumour markers (PSA) or other systemic conditions.

Treatment depends on the underlying cause. If an infection is present, antibiotics may be prescribed. Anti-inflammatory medications may be used for inflammation. In cases where an obstruction or structural abnormality is identified, surgical intervention might be necessary. Dr Sangster carries out seminal vesicle washouts if the bleeding does not settle down. Occasionally if there is a blockage of the ejaculatory ducts or seminal vesicles, a TURED (transurethral resection of ejaculatory duct) will be carried out. Both are general anaesthetic, day case procedures.

In summary, haematospermia is the presence of blood in the semen and can be associated with a variety of benign and serious conditions. While it is not a direct cause of infertility, underlying conditions contributing to haematospermia can impact male fertility. Accurate diagnosis and appropriate treatment are crucial for addressing both the haematospermia and any related fertility issues.