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What is hematospermia, and what are its major causes?

Hematospermia is the presence of blood in the seminal fluid. The majority of cases of transient hematospermia in men <40 years of age are benign and self-limited and are not due to significant underlying disease processes. These patients are treated with conservative management. In men ≥40 years of age, or in those with other associated symptoms or signs of disease such as persistent hematospermia, TRUS or MRI can be used to evaluate for underlying pathologies including prostate cancer.

Major causes of hematospermia include:

  • • Idiopathic (the most common cause).
  • • Prior biopsy.
  • • Cysts, calculi, or calcification in the prostate gland or ejaculatory tract.
  • • Calculi or calcification.
  • • Benign prostatic hyperplasia (BPH).
  • • Inflammation or infection.
  • • Prostate cancer.

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