Hemospermia: what is it exactly?
As the name suggests, hemospermia refers to the presence of blood in semen. ” It is a symptom that is rarely serious, reassures us from the outset Dr. Antoine Faix, urological surgeon. On the other hand, if it is not necessary to go immediately to the ER when a few drops of blood are observed in his semen, it is best to see a doctor if this repeats itself – preferably a doctor. urologist. “
In the majority of cases, hemospermia is linked to an infection of the prostate or seminal vesicles: ” you should know that the sperm is produced in the amount of 60% by the seminal vesicles, 30-35% by the prostate and the rest by the urethral glands and others, with a very small proportion of sperm “says Dr. Faix.
Warning : hemospermia (presence of blood in semen) should not be confused with hematuria (presence of blood in urine).
Hemospermia: this is often an infection
Most often, hemospermia reveals the presence of an infection of the prostate and / or seminal vesicles. ” In young men (20-30 years), we spontaneously think of a sexually transmitted infection (STI) “notes the urologist. The most common culprit is the bacteria Chlamydia trachomatis, responsible for chlamydia.
In both men and women, the bacteria Chlamydia trachomatis spread through sexual contact with an infected person – genital, anal, oral or oral sex. In 60% to 70% of cases, the chlamydial infection is asymptomatic; in humans, the bacteria Chlamydia trachomatismay possibly cause hemospermia, burning when urinating (urination burns), testicular pain and / or rectal pain.
” In older men (after 60 years), although STIs cannot be ruled out, we will rather think of a urinary tract infection affecting the prostate – we also speak of prostatitis “specifies Dr. Antoine Faix. The culprit bacteria is usually Escherichia Coli (E.Coli). In the event of prostatitis, hemospermia and / or hematuria may be observed, but also fever (above 38 ° C), burns when urinating (urination burns), frequent urges to urinate (pollakiuria) and / or pain (pelvic, perineal, urethral, penile and / or rectal).
After a clinical examination, an interrogation (has the patient had unprotected sex?) And a urinary cytobacteriological examination (ECBU) intended to identify the germ responsible for the infection, possibly supplemented by an examination of semen, the urologist may prescribe antibiotic drugs.
Hemospermia: there may be a question of prostatic fragility
The presence of hemospermia can also be linked to a fragility of the prostate: the small blood vessels that run through this gland can indeed rupture, causing a small loss of blood in the semen.
” This particularly applies to older men, who possibly suffer from benign prostatic hyperplasia (BPH) and / or who are being treated with medication anti coagulants or anti-platelets following a vascular problem (pulmonary embolism, heart problems, etc.) “explains the urological surgeon.
More rarely, hemospermia can result from prostatic trauma: a kick in the perineum, for example. ” A special case is that of patients who have undergone a medical trauma, for example a prostate biopsy: blood can then be observed in the semen and hemospermia can persist for several weeks after the medical procedure. “adds Dr. Antoine Faix.
Hemospermia: we think of prostate cancer
In France, around 50,000 new prostate cancer are diagnosed each year: this exclusively male pathology is responsible for around 9,000 deaths per year. It is the most common cancer in humans and in the general population.
Exceptional before the age of 50, prostate cancer mainly affects men over 70, and especially those of African or Caribbean origins. There is a family risk factor. Symptoms of prostate cancer include:
- Hemospermia (blood in semen) and / or hematuria (blood in urine),
- Difficulty urinating (a weak urine flow or which is easily interrupted, a need to “push” while urinating …),
- A burning sensation or pain when passing urine
- Frequent and urgent need to urinate (pollakiuria).
Faced with these symptoms, in addition to the clinical examination, the urologist may prescribe a blood test (dosage of PSA) and a biopsy in order to identify possible cancer cells.
Thanks to the Dr. Antoine Faix, urological surgeon, andrologist and sexologist, treasurer and administrator of the Association Française d’Urologie (AFU).
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