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QUESTION: About 2 years ago just before i was going to ejaculate i squeezed my penis real hard to stop it. after that I started to have some blood in the urine when I would empty my bowels and kind of try hard. in addition i started noticing some blood in my semen.Saw a urologist did some tests like MRI with contrast, sample of prostate fluid showed nothing, I also got some antibiotics initially which didn't stop the bleeding.we also did urinalysis and ultrasound of the bladder. the Dr wasn't clear about the diagnosis but did ask me to take Finasteride and Amitriptyline which I took for only short period of time, without finishing it. Recently I saw another urologist to whom I described my problem as blood in the semen, of course i filled out all  those forms and i did say that my urine flow isn't that great.(I'm 60 years old)he started by doing a cystoscopy, he said that this would allow him to know exactly what my problem is. He diagnosed that I have High riding prostate and explained that that means my prostate is positioned in a "wrong way" and that it has nothing to do with my initial trauma.as a matter of fact he totally disregarded my story. he prescribed Flomax and said that i might have to take it for the rest of my life. your opinion please.
Thank you.

ANSWER: Ben:

It is hard to see how squeezing the penis would cause blood in the urine, especially long term and with a negative cystoscopy.

Blood in the semen called hematospermia is almost always self-limiting and usually needs to treatment.

A high riding prostate is possible, but this usually refers to severe injuries like after a car accident where the prostate has been ripped off its base.  

The bottom line is that if you have voiding trouble and the flomax helps, take it.  You might want to consider an opinion from a tertiary care university urology department to get this all straight.

---------- FOLLOW-UP ----------

QUESTION: Thank you Dr.
Just to clarify. Is it theoretically  possible to cause that kind of a prostate injury by putting a lot of pressure on the penis when its in full erection just before ejaculating ? also when i empty my bowel,and push real hard to evacuate, would that cause bleeding especially after that injury.?
And lastly what kind of tests would I need at the university urology department, considering the fact that I have had all these tests done already.
thanks for your patience.

ANSWER: Ben:

While almost anything in medicine is possible, a major protate injury is not possible by just squeezing the penis.

Pushing hard with a bowel movement can cause some pressure on the prostate, but should not cause any bleeding.

It is not appropriate for us to suggest tests at the tertiary care center you may go to.  That's their job.  However, many such institutions will want to repeat some or all of the tests, especially in a case like yours where the source of the bleeding has escaped detection.

---------- FOLLOW-UP ----------

QUESTION: Upon reading your comments again I realized that one of your comments was very confusing to me. I'm referring to you writing that:
A high riding prostate is possible. Can you clarify that statement. Possible in what way? Also another sentence didn't make sense:
Blood in the semen called hematospermia is almost always self-limiting and usually needs to treatment. Did you mean NO treatment?
Thanks,

Answer
Ben:

A high riding prostate usually suggest a severe, post traumatic injury which is obviously not what your surgeon meant.  In explaining complex problems in layman's terms, its possible that he was actually explaining some other problem.

From here, I can't guarantee that you don't have a high riding prostate or any other problem so don't read too much into these statements which are intended to be for general information.

Small typo.  No treatment for hematospermia is usually required.

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Stephen W. Leslie, MD

Expertise

Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.

Experience

Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

Organizations
American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Publications
Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Education/Credentials
Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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