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HAEMOSPERMIA


Characterized by with red or brown ejaculate (semen), this ejaculation disorder can be defined as "presence of blood in semen". While haemospermia can be more frequently seen in young, sexual active 30-40 years of age, it can be seen in any age following puberty. It recurs with 80-90 % likelihood. While it automatically vanishes after approximately one month in half of the cases, it may continue for a period of 2 years. It emerges due to the benign reasons such as infection and inflammation in young men; furthermore, cause of haemospermia may not be fully defined. It is frequently painless. It causes fairly much concern in patients fearing of cancer and sexually transmitted diseases.

Semen (seminal fluid, ejaculate, semen) is a fluid originating from several organs or ancillary sexual glands. Testes are organs constituting seminal duct, seminal vesicles, bulbourethral gland and prostate semen. Two organs contributing most are prostate and seminal vesicles and bleeding is mostly resulted from these two organs. Blood is only present in most of the patients and blood is not generally detected in urine. Blood is detected in urine in other patient groups and these patients with blood detected in their urines require more detailed investigation. Haemospermia can be an underlying symptom of a cancer in small (less than 5%) phenomenon. Probability of underlying serious disease is virtually impossible in young patients with no blood cell encountered in urine analysis having only haemospermia (hematuria), not having any other complaint, not having any infection symptoms in urinary tracts and not detecting any anomaly in physical examination. Scientific studies conducted have demonstrated that haemospermia is benign and is limited within itself in most cases; haemospermia automatically vanishes without conducting any treatment in these patients and it does not recur in 15 % patient and it recurs in other patients. What is here main principle to conduct basic analyses following first evaluation in these patients and patients are informed and eliminate major concerns of patients. These patients are generally monitored and followed up without administering any treatment. Patient is advised to apply for again if case of any complaint rather than blood ejaculate to patient. (such as blood presence in urine, burning while urinating)

Underlying causes in approximately 80 % of patients can be identified with modern monitoring techniques. The factors determining extent of the analyses to be conducted are that patient is over 40 years of age, term of haemospermia, whether it is persistent or not and accompanying hematuria. The most sensitive method used in monitoring ancillary sexual glands and ducts contributing semen in our time is magnetic resonance imaging technique. When compared with transrectal prostate ultrasonography, the most important advantage herein is capability of detecting seminal vesicles and bleeding in prostate however this is more costly. Urologist may require examine lower urinary tracts and prostate via cystourethroscopy investigation that is a type of endoscopic analysis in patients with blood detected in especially urine analysis. Directly visual lower urinary tracts examination is conducted and in this way, urethra tumours, foreign bodies in urethra, prostate cyst, stone and vascular abnormalities can be detected. In addition, prostate, bladder neck and inner wall are checked. During this operation, any bleeding vein detected can be burned and treated and piece can be taken for the purpose of biopsy from tumours or can be fully cut and removed.