Premise
In the previous discussion, we analyzed the problem of blood in sperm in terms of incidence and causal elements: in this final article the condition will be treated from a diagnostic and therapeutic point of view, after having classified the various types of hematospermia.
Classification
On the basis of the clinical characteristics of the blood in the sperm, it is appropriate to carry out a precise classification: in this regard, one distinguishes purely bright red blood from darker blood (brown or black) within the seminal fluid.
When hematospermia becomes a particularly recurring problem, the blood emitted together with the sperm, during ejaculation, tends to become darker, varying shades from brown to black. In almost all cases, patients who complain of episodes of brown blood in the semen have also previously witnessed emissions of bright red blood into the semen. Brown or black blood is the consequence of blood residues previously accumulated in the prostate or seminal bladder: due to oxidative processes, the color of the blood varies from bright red to burgundy - brown.
Diagnosis
The spermiogram certainly represents the most suitable diagnostic test for the recognition of any pathogens in the sperm. Spermioculture, on the other hand, completes the spermiogram and gives an idea of the type and quantity of microorganisms present in the seminal fluid.
When the patient, after the age of 50, complains of episodes of blood in the sperm, a thorough test of the prostate should be carried out: the abnormal swellings and any abscesses could be responsible for the bleeding in question. When the anorectal medical palpation is not sufficient, the patient will have to undergo a "trans-rectal ultrasound, certainly more precise than manual control: the latter" highlights other hypothesized pathologies, such as stones, prostate cysts, ejaculatory ducts or prostatic calcifications.
The PSA test (Specific Prostate Antigen) is a diagnostic screening test useful to exclude the possible possibility of prostate cancer.
Periodic monitoring of blood pressure is advisable, especially in those aging patients: we have seen, in fact, that hypertension could represent a risk factor for haematospermia.
Furthermore, in order to ascertain whether the bleeding in the semen derives from a prostatic or urethral morbid condition, cystoscopy and urethroscopy are recommended, respectively.
In case of suspected sexually transmitted infection, related diagnostic tests are appropriate.
Blood in semen: therapies
When a particular cause is not identified, the treatment is empirical, therefore based on observation. Even in similar situations, some therapists still recommend the administration of tetracycline for a period ranging from 5 to 7 days, possibly associated with a prostate massage.
When the prostate biopsy ascertains the detection of pathogenic microorganisms, the patient is usually treated with antibiotics, possibly associated with anti-inflammatory phytotherapics. The administration of NSAIDs for prolonged periods is not recommended, as it could worsen the haematospermia.
Some patients complain of blood in the sperm due to a narrowing (stenosis) of the urethra: in such situations, some urethral dilators may be useful, while in the most severe cases a surgical operation is essential.
However, these are sporadic cases, in which blood in the sperm certainly does not represent the main problem, but only a secondary symptom, a consequence of more severe genital conditions. When cardinal disease is treated, even hematospermia will no longer be a concern.
More articles on "Blood in sperm: classification, diagnosis, therapies"
- Blood in the semen
- Blood in sperm in brief - Hematospermia Summary table
