Treatment

Depends on cause.

Management in primary care if no identifiable cause (1):

• for men younger than 40 years of age who have had no more than three episodes of haematospermia within one month:
  • reassurance that a serious cause is extremely unlikely
  • the patient should be advised to return if more than three episodes of haematospermia occur or episodes of haematospermia continue for more than one month
    • the guidance as to what to do in this situation is conflicting
      • For example Oxfordshire NHS guidance suggests that referral is not indicated unless haematospermia is recurrent over 4-6 months (4) whereas other guidance suggests this situation warrants referral for specialist review without further observation in primary care (5)
        
        
• for men of 40 years of age or older, those who have experienced more than three episodes of haematospermia, and those experiencing episodes of haematospermia for more than one month
  • then refer to a urologist for further assessment
  • note though that RCGP guidance suggests referral if only a single episode of haematospermia if age > 40 years of age (2)
    • specialist urological assessment and investigations is indicated for patients with recurrent haematospermia or if the patient is > 40 yrs old (2)

Reference:

• (1) CKS (Accessed 3/12/2013). Haematospermia.
• (2) Royal College of General Practitioners (RCGP) 2006. Sexually transmitted infections in primary care
• (3) Stefanovic KB, Gregg PC, Soung M. Evaluation and treatment of hematospermia. Am Fam Physician. 2009;80(12):1421-7
• (4) Oxford Primary Care Trust (Accessed 3/2/13). Oxfordshire Urology guidelines.
• (5) NHS Kernow Clinical Commissioning Group (Accessed 3/2/13). Haematospermia.