aetiology

Last reviewed 01/2018

• up to 1/3 of cases are idiopathic
• 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