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: (NHS Evidence)


  • 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.