Definition: Blood seen within the ejaculate
- Consider referral in those >40y, or abnormal PSA or >3 episodes.
- No evidence of the value of additional urological tests that may include USS Renal, Trans-rectal USS; cystoscopy is rarely undertaken.
- Exclude haematuria
- Exclude other inguino-scrotal abnormality (eg scrotal mass)
Management prior to referral:
- Reassure when appropriate: invariably benign disease, albeit distressing and concerning.
- Exclude STI and bleeding diathesis
- PSA test
- If PSA normal, in those < 40y with <3 episodes reassure and do not refer.
NICE, CKS Haematospermia, January 2017
Mr Christopher Blake, Consultant Urologist, RCHT
Dr Stephanie Jackson, GP Lead Urology
Reviewed: July 2018