Peter Hibberd, M.D., is a doctor whose advice is based on more than 28 years of hospital outpatient and inpatient experience. He is an experienced emergency medicine physician, surgeon, and consultant. Dr. Hibberd is certified by the American Board of Emergency Medicine. He is also a fellow and active member of the American Academy of Family Physicians, an active member of the American College of Emergency Physicians, and a member and fellow of the American Academy of Emergency Medicine. Dr. Hibberd has earned numerous national and international professional certifications, memberships, and awards.

Should Unexplained Bleeding be Cause for Concern?

Friday, 18 December 2009 09:16 AM

Question: I am 76 years old and have blood in my semen, but my PSA indicated no problems. My doctors are reluctant to discuss this with me. Any advice?

Dr. Hibberd's Answer:

Malignant changes may occur in any tissue, and although rare, the male reproductive tract is no exception. Statistically, hematospermia is usually of no consequence. Despite the statistics, however, bloody secretions are ALWAYS grounds for further evaluation. I recommend you seek advice from a urologist (specialist for male reproductive area). If the cause and source of your bleeding is not evident to your physician after a complete history and physical examination, you will need further evaluation.
While the cause may be a simple urethral stricture or even a chronic prostatitis, a malignant change needs to be checked for, and the condition corrected before it spreads or advances in severity. Usually a cytological examination of your semen and your urine will help establish whether this is related to a benign or malignant condition. Cultures and DNA probe assays will help identify any sign of infection. Appropriate imaging such as ultrasound or MRI may prove to be very useful in isolating the cause of your hematospermia if the source is still unclear and if a tumor (benign, malignant or abscess) is suspected.

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