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