Question: hello doctor. i wrote you 2 years ago on this site.
i had a recurrence of hematospermia again 5 weeks ago. i had sex three times and ejaculated blood every single time. i urinated after having ejaculated and blood came out with a clot at the end. i then had sex 2 weeks later and no blood appeared. i had sex today and blood appeared again in the semen. i haven´t urinated since the ejaculation yet.
differences that i noticed: i was very erect the times i ejaculated/urinated blood. the time i didn´t was when my penis was not fully erect. i have tried to find a cause, changed my eating habits, gone to shamans, mediums, tried acupuncture, macrobiotics, exercise, etc. no one has found any thing to be wrong with my urinary system apart from a high psa in 2005 (when the problem began). a cystoscopy performed on one of the days that i bled found no blood anywhere. the last physician i saw said its a mechanical problem. i have found no pattern when it comes to alcohol abuse, bad eating, feeling nervous, etc. could it be that this is actually a mechanical problem? ie that a blood vessel pops? i ask because i had hematuria twice after an erection. i did not ejaculate before or after. i just had an erection and went to urinate and blood came out. this perhaps might be the ´´catch´´. i do psa tests and rectal examinations minimum once a year. the prostate is not abnormal in size, i have no std or bacteria (i doubt the bacteria would be around since 2005).
i felt pain and discomfort in the groin and anus 2 weeks prior to ejaculating blood this time. i actually ´´felt´´my body and was waiting for the blood to appear again. usually i feel buzzing sensations and other feelings associated to ´´prostatitis´´during the blood cycle. for the first time i felt these things prior to ejaculating blood. i usually ejaculate a lot quicker when i am in this phase and urinate a lot..at times it feels like i urinate more than i drink. i had a prostate biopsy done on me in 2005. last cystoscopy was 2 years ago. could it be that my immune system is letting me down or that i need something to strengthen my blood vessels? today is the first time it took me more than 1 hour to urinate for the first time after ejaculating.
hematospermia before today was always followed by dark red urine and a clot at the end.
today the urine came out brown with a minute clot.
i understand why it came out brown but cannot fathom the small size of the clot as compared to when the blood was dark red.
i mention again that he only thing i notice is that blood appears when i am very erect and sexually excited. i do not recall having passed blood in my semen after masturbating.

Dear Dr XXXXXXX
Thank you for your help.
To answer your questions:
1) Have you ever done semen culture any time and what was the results.?
Yes. There was nothing abnormal. I recall that one doctor found UU. But this appears to be normal, even though he thought it was alarming. Every Doctor that performed semen culture told me my semen was good and would ´´make good babies´´.
2)Have you done screening tests for STD ?
Yes. The last time was a year ago. Which tests do you suggest I do? There are loads of STDSs around.
3)Have you done blood testing for coagulation profile ?
Yes. Coagulation is good.
4)Have you done Colour Doppler Ultrasound Scanning of Penis ?
No, I have never heard of it. I will check online. Could you give me some valid info please?

I just remembered something strange.
In 2005 I had verruga warts come out under my feet. 2 weeks later i had my first incident of Hematospermia. 7 weeks ago I had verruga warts again for the first time since 2005. I felt pain in the groin and anus, and two weeks later Hematospermia appeared again.ps
I suspect that a cause might be the following. I have gone through years of ´´paranoia´´ and trying to understand how my body works.
Could it be that if the penis is not fully erect, one is actually forcing his body too much to ejaculate? I mean, forcing yourself to ejaculate even though you are not sexually over-excited?
If this is the case, wouldn´t it be possible for an ejaculation from a full erection to cause blood to appear?
What exactly is the mechanism that causes an ejaculation?
Please recall that I urinated blood twice after sexual arousal and an erection without having penetrated/engaged in sex etc.
As for the STDs or infection, wouldn´t something had appeared over the years?

Regards

Dear Dr XXXXXXX

I have taken antibiotics over the years, and for more than 2 weeks in a row, with no results.
How about Fungus? Might this be a cause? Are there any tests for this?
I had a fungus outbreak/rash on my hand approx 3 years ago.
I will try the Penis and Testicular Doppler this week.
I have one more piece of information: sometimes I wake up and have a very strong erection. This is not sexual arousal, it is the urge to urinate.
I never passed blood after having an erection like this. So it must be sexual arousal that causes the blood.
What do you think?
Regards

thanks for your help.
blood pressure is fine.
i will do the check ups you suggested this week.
i know that a morning erection is normal. but my point is that it is normal because my body wants me to urinate. its not an erection caused by sexual arousal.
can you please explain what organs are responsible for an erection as a result of the need to urinate and what organs are responsible for an erection as a result of sexual arousal (if there is a difference)? this might be of help.
like i said, the only time i passed blood in urine was after sexual arousal without ejaculation.
this comes to my nexty question.
the doppler test will start with an injection to give me an erection.
this however will not be caused by sexual arousal, so what would this be done for?
regards

thanks for your message.

so far i got these results for the stds:

hepatitis b and c NEGATIVE
hiv NEGATIVE

the rest will be out this evening.

psa 1,12

regards

dear dr XXXXXXX

here it goes:

venereal disease research lab not reactive

rapid plasma reagin test not reactive

both ecos found nothing wrong whatsoever.
i was not injected the liquid because the dr told me that it done for people with erectile dysfunction.

i had sex 1 hour before doing the ecos in case blood appeared. no blood appeared in the semen/urine.
do you suggest i do them again if bleed again?

regards

hello . do you suggest another doppler as i described in my previous message?

dear dr,
would a doppler not show where the blood came from and coagulated if i were to do it an hour or so after ejaculation?
is there any type of medicine that strengthens the veins or improves the blood flow/coagulation?
i know that its good that no harmful bacteria/cancer/etc has been found...but i can´t continue my life bleeding every once in a while without knowing the cause because some other factors have been ruled out.
regards

dear dr XXXXXXX
well i never mentioned erectile disfunction.
i said that i passed blood twice in my urine after an erection without having ejaculated before.
how could that be regarded as being erectile dysfunction?
i told you that i noticed that if the erection is very hard/stiff due to high sexual arousal, i pass blood sometimes. if i am not that aroused (which happens to every man, depending on his partner, his mood, what he did that day before having an erection, nerves, etc), that i do not pass blood.
to make you understand: if it is 100 per cent hard i tend to pass blood..even if i don´t have sex or ejaculate, as i told you which was the case when i urinated blood.
if i am masturbating or not very sexually aroused no blood comes out.
why did you suggest that i test my erectile dysfunction?
the doctor that did the ecos yesterday found it odd as well..that is why he did not inject me.