Haematospermia is the presence of visible blood in the semen. It looks pretty dramatic when it first happens,sometimes terrifying, because essentially the entire ejaculate, would seem to be replaced by fresh blood. With time it tends to settle down, it goes through a phase of being more rusty coloured, before eventually clearing. Because of that we don't really know how many men in this country suffer from haematospermia because they can be too embarrassed to see the GP to get assessed. We do recommend at Manchester Urology all patients with blood in the semen do get an assessment because although for the vast majority of patients there is no sinister or worrisome cause behind it, it can be associated with both waterworks infections and indeed prostate cancer. For the man under 40 there is maybe a 1 in 8 chance he will have an infection as the cause and maybe one of 50 chance of prostate cancer. For the man over 40 years old, 1 in 10 will have an infection howevevet on investigation we will find prostate cancer associated with this haematospermia in as many as 5 or 6% (1 in 20).
So whether a single episode or multiple episodes we recommend a man gets assessed. That assessment can be performed rapidly and is relatively non-invasive. It requires a clinical history, an examination, a urine sample, blood pressure test and often PSA prostate specific antigen blood test.