Aetiology

• up to 1 in 3 cases are idiopathic
• persistent cases are more likely to be secondary to detectable underlying pathology
• in patients under 40 years of age, urogenital infection is the commonest cause (particularly prostatitis and seminal vesiculitis). Occasionally urethritis and epididymo-orchitis might result in haematospermia. Rare causes include schistosomiasis, tuberculosis and urethral condylomata.
• other causes include:
  • trauma to the perineum or testis
  • dilation of seminal vesicle
  • ejaculatory duct cysts
  • prostatic calculi
  • polyps in the prostatic urethra
  • urethral stricture
  • venous abnormalities in the prostatic urethra
  • prostate cancer may present with haematospermia
• other disorders e.g. coagulation disorders, may occasionally be associated

Reference

1. Dantanarayana N. Aust Fam Physician: Haematospermia. Volume 44, Issue 12, December 2015