Last reviewed 01/2018

Depends on cause.

Management in primary care if no identifiable cause (1):

  • for men younger than 40 years of age who have had no more than three episodes of haematospermia within one month:
    • reassurance that a serious cause is extremely unlikely
    • the patient should be advised to return if more than three episodes of haematospermia occur or episodes of haematospermia continue for more than one month
      • the guidance as to what to do in this situation is conflicting
        • For example Oxfordshire NHS guidance suggests that referral is not indicated unless haematospermia is recurrent over 4-6 months (4) whereas other guidance suggests this situation warrants referral for specialist review without further observation in primary care (5)

  • for men of 40 years of age or older, those who have experienced more than three episodes of haematospermia, and those experiencing episodes of haematospermia for more than one month
    • then refer to a urologist for further assessment
    • note though that RCGP guidance suggests referral if only a single episode of haematospermia if age > 40 years of age (2)
      • specialist urological assessment and investigations is indicated for patients with recurrent haematospermia or if the patient is > 40 yrs old (2)