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.  


Reg Flags: 

  • 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