HEMATOSPERMIA:
Dear Sumner:
Robert, who is a 44 year old man, will be seeing you in the near future. He recently discovered blood on the sheets after having had intercourse with his wife. She was not having her period at the time. He did not see any blood in his urine, and there was no associated discomfort with either urination or ejaculation. Needless to say, he has since been VERY upset, and is convinced that there is something seriously wrong. He denies any new sex contacts, although he is now wondering if this is from some pre-marital “exposure.” I tried to reassure him that the underlying condition is most likely not serious, but I think he needs your special touch. I await hearing your words of wisdom.
Dear Martha:
I can certainly understand Robert’s distress. The presence of blood in the ejaculate is very frightening to a man. He verbalized to me that he was afraid he had a malignancy, a venereal disease, or that this might portend the loss of his ability to have erections! He seemed a bit more relaxed when I explained that bloody ejaculates (aka hematospermia), fortunately, is almost always benign in nature caused by an underlying inflammatory process. The bloody ejaculates are usually of brief duration, although in some cases they may persist for years. A urine specimen sent for cytological examination, as expected, showed no malignant cells. I told him that if the bloody ejaculates did persist, I would get x-rays of the area and possibly look up into his urethra and bladder. When he asked what he should do if all of the studies showed no serious underlying problem and yet the bleeding recurred. I advised him to have sex in the dark.
