Hematospermia usually results from either inflammation of the prostate or seminal vessicles. If you notice more blood in the initial portion of the ejaculate it usually implies the prostate and if more in the terminal component, the seminal vessicles. If this were acute bacterial prostatitis he would most likely have several symptoms which would include pain, fever, dysuria, and usually either perineal or suprapubic pain. There would also be significant tenderness with rectal examination and palpation of the prostate.
Depending on the symptoms that occur with the hematospermia, this drives the workup and treatment. If symptoms suggest acute bacterial prostatitis (fever, pain, dysuria).. a CBC, UA, culture, pain and boggyness with prostate palpation ...antibiotics are warranted.
If hematospermia from mere irritation is involved, a UA, rectal exam with prostatic message and examination of the expressed prostatic secretions are involved with various other testing possible depending on the initial findings. Treatment for this does not usually require antibiotic management.
Based on your boyfriend's symptoms, it does not suggest bacterial prostatitis as he is non-symptomatic between ejaculations and has no other constitutional symptoms. Still should be evaluated by a physician with the proper studies being performed.
Just FYI, prostatitis is a general term for inflammation of the prostate. This can be due to any number of factors including infection or trauma. It is very possible that his colonoscopy could have bruised and irritated the prostate causing his symptoms. Prostatitis is not an uncommon problem following instrumentation or trauma. Once again it is doubtful that this represents acute bacterial prosatitis given the lack of other symptoms nor would it suggest chronic bacterial prostatitis as he never had the acute symptoms, nor has the duration of his symptoms been long enough to classify it as such.
Once again, he should see his MD for evaluation.
RAM MD
Posted: 23 Sep 07:13
