Hemospermia is characterized by the presence of red or dark brown blood in the ejaculate, which must not be of female origin or the result of a ruptured frenulum. It is a source of anxiety because the blood often makes one think of the worst possible scenarios. Its incidence is difficult to determine because not all people will consult for this symptom, especially in the event of a single episode without a follow-up. It is nevertheless a relatively frequent reason for consultation and occurs most often in young people, aged less than 40 years.¹⁷.

What possible causes for hemospermia?

Most of the time (30 to 86% of¹⁸), hemospermia is the reflection of a benign, infectious or inflammatory pathology, especially in young people.

It can be a bacterial, viral or parasitic infection:

– a bacterial infection with banal germs (prostatitis, vesiculitis, urethritis, pseudomonas, etc.)

– infection with intracellular germs

– genitourinary tuberculosis

– infection with human papillomavirus (condylomes uréthraux)

– cytomegaloviruses

– schistosomiasis

In the event of a single episode, especially in young people, the anxieties must be alleviated if the minimal assessment (a cytobacteriological examination and a rectal examination) does not detect anything suspicious.

In the event of recurrence, however, it will be necessary to look for other possible causes (non-exhaustive list):

– Cysts and obstructions of the ejaculatory ducts, seminal vesicles,…;

– Hemospermia “ex vacuo” which can occur in some after a long abstinence¹⁹ ;

– Tumor causes: benign and malignant tumors (5 to 10% of hemospermia cases) especially in people over 40 years old;

– Vascular causes: varicose veins of the urethra or bladder neck, fistulas;

– Systemic causes: cirrhosis, willebrand disease…;

– Traumatic causes: blows, falls, etc.