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Dr. SH
Dr. SH, Board Certified Physician
Category: Medical
Satisfied Customers: 8753
Experience:  Doctor of Medicine
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I am an Asian Chinese male, 54 years old soon. I am having

Resolved Question:

I am an Asian Chinese male, 54 years old soon. I am having blood in the semen which started about 2 months ago. When I first visited the doctor, I was prescribed with 1 week of antibiotics (ciprofloxacin) and cranberry forte. After 1 week, I then went back to the doctor for the urine and blood samples to be taken.

A few days later, I did 2 ejaculations and found there was no more blood in the semen (but the fluids or sperm came out seemed a little amount).

The urine and blood results came out not long later, they were normal. There was totally no traces of blood in the urine and the total PSA result was 0.4. The doctor prescribed me with another 1 more week of the same medications and told me need not go back to see him unless there is something wrong.

I waited for another 2 weeks later and did the ejaculation, this time the blood was there in the semen again ! It was dark red in colour which slowly flowed out without any pressure. I quickly went back to see the doctor who sent me for the ultrasonic scan on the urinary bladder, kidneys and the prostate gland.

The findings from the ultrasound scans as given in the reports, are as follows:
---------------------------------------------------------------------------------------
Ultrasound Kidneys & Urinary Bladder:
The kidneys are of normal size, position, echogenicity, and cortical thickness. There is a good definition of the cortico-medullary junction. There are a few cysts noted in both kidneys, the largest in the right kidney 1.3x1.0x0.9 cm and in the left kidney measuring 0.7x0.8x0.6 cm. No obvious renal stone, hydronephrosis or focal renal mass lesion is detected.
Ultrasound of the urinary bladder reveals no obvious calculi or mass lesion.
Conclusion:
1) A few simple cysts are present in both kidneys.
2) No focal renal is detected.

Ultrasound Prostate Gland:
Both transadominal and transrectal scans were performed.
The prostate gland is normal size. The echogenicity is homogeneous. No focal hypoechoic module is seen in the peripheral zone or central zone. A focus of calcification is detected.
There is a cyst measuring 0.2 x 0.0 cm noted.
The seminal vesicles are intact.
Urinary bladder configuration is ormal with no base indentation. There is no significant residual urinary volume following micturition.
Conclusion:
1) The prostate is not enlarged.
2) Non-specific prostatic calcification is noted.
3) No focal lesion or abscess is detected in the prostatic gland.
---------------------------------------------------------------------------------------------------

My doctor told me the cysts are present which could have caused the blood in the semen and for the time being there is no need to worry about prostate cancer in there.

I was given another 3 days of the same antibiotics to finish them off. However, about 1 week later or just recently, I again found blood in the semen but light red (not dark red) in colour !

Questions:
-----------
1) Why again there is blood in the semen when the PSA and the ultrasound scans results
showed normal ?
2) Could it be that blood come from the cysts ?
3) Was there still inflammation inside the prostate gland, seminal testicles ... etc?
4) The test was not conducted on the testicles which produce the sperms. Do you think
there might be a problem in that areas?
5) Could continuous or longer period of consumptions of the antibiotics help clear the
symptom or eradicate the whole problem ?

Thanking in advance and looking forward to receiving your reply soon.

Yours Sincerely,
Simon
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. SH replied 2 years ago.

Dr. Shahzad MD :

Hi there. Thank you for your question. I will be helping you out with your queries

Dr. Shahzad MD :

welcome

Dr. Shahzad MD :

Blood in the semen in the VAST MAJORITY of the cases is not something serious and usually signifies a minor injury to blood vessels in the urinary tract that is causing the blood to appear in the semen.

Dr. Shahzad MD :

In the majority of people this will go away on its own in sometime to come.

Dr. Shahzad MD :

Its not from the cysts.

Dr. Shahzad MD :

I do not think that there was inflammation in the prostate or seminal vesicles.

Dr. Shahzad MD :

I also do not think that there was a problem in the testicles.

Dr. Shahzad MD :

If you had a problem in the testicles you would have had pain in the testicles usually.

Dr. Shahzad MD :

I think that with time as the area heals up you should be fine. Meanwhile you should abstain from sex and masturbation for at least a couple of weeks to allow it time to heal up.

Dr. Shahzad MD :

Are you following me?

Customer:

How can I am be sure when there is still blood in the semen ?

Dr. Shahzad MD :

Have you had your semen tested or prostatic fluid tested?

Dr. Shahzad MD :

Please scroll up to read all my responses if you have not done so already.

Customer:

Should I ask my doctor again for antibiotics ?

Dr. Shahzad MD :

NO

Dr. Shahzad MD :

I do not think that you require any more antibiotics.

Dr. Shahzad MD :

I think that you may want to give it some time for it to heal up completely.

Customer:

No, I have not have the semen tested yet.

Customer:

I am just wondering while having sex that if I keep holding back the sperms or fluid from coming out, will it cause any injury to the testicles or elsewhere inside?

Dr. Shahzad MD :

Yes

Dr. Shahzad MD :

Most likely its due to injury to the tiny blood vessels in there causing the blood to appear in the semen

Customer:

When I passed urine, I noticed that often the urine comes out split not in a single flow. The urine seems to be foamy many a time. Does it indicate there is something wrong ?

Dr. Shahzad MD :

Foamy urine may mean some protein coming out in the urine but since you have had a normal urine tests that must be ruled out.

Dr. Shahzad MD :

Other than that, since your tests are normal I would not worry.

Customer:

Is there any way I can do to check myself if there is no problem with the testicles ? What's next that my doctor will do if there is still blood in the semen after

Customer:

Sorry, I just want to know what can be wrong next if there is still blood in the semen after I abstained from sex or masturbation for couple weeks.

Dr. Shahzad MD :

I think that you need to have a semen or a prostatic fluid test done to have a look.

Dr. Shahzad MD :

If you have blood in the semen even after two weeks of abstinence then you need to have a semen test or a prostatic fluid test done.

Customer:

Thank you. It should be fine for the time being. I will wait for couple of weeks later and see if there is no more blood in the semen. Final questions:

Customer:

Final questions:

Customer:

Final questions: 1) In order not to cause further injury to the vessels, can I still do normal physical exercises such as jogging or lifting of goods ? 2) Inhaling of the foam packing materials will it cause harm to the prostate or other tissues resulting in inflammation. The reason I am asking is because I remembered I had the blood in semen a day after having inhaled some of these material.

Customer:

One last question, why didn't think or suspect that the blood in semen is due to prostate cancer or testicles cancer or other types of cancer. Are PSA and the ultrasound test results reliable ?

Dr. SH, Board Certified Physician
Category: Medical
Satisfied Customers: 8753
Experience: Doctor of Medicine
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