persistent cases are more likely to be secondary to detectable underlying pathology
in patients under 40 years of age, urogenital infection is the commonest cause (particularly prostatitis and seminal vesiculitis). Occasionally urethritis and epididymo-orchitis might result in haematospermia. Rare causes include schistosomiasis, tuberculosis and urethral condylomata.
other causes include:
trauma to the perineum or testis
dilation of seminal vesicle
ejaculatory duct cysts
prostatic calculi
polyps in the prostatic urethra
urethral stricture
venous abnormalities in the prostatic urethra
prostate cancer may present with haematospermia
other disorders e.g. coagulation disorders, may occasionally be associated
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