AboutArthur Goldstein, M.D. Expertise Any problems or questions related to the field of urology; ie urinary stone disease, urinary cancers (kidney, bladder, prostate, testis, etc.), urinary infections, impotency, etc.
Experience I am retired from the active practice of urology. My 34 years was totally in the clinical field and involved the entire gamut of genitourinary problems, with special interest in male impotence and endourology.
Organizations American Medical Association, American Urological Association, American College of Surgeons
Question Doc, I would sincerely appreciate your insight on this matter.
I had sex two nights ago, and suffered a possible injury to my penis/urethra.
The position I was in caused alot of pressure and rubbing on the pelvic bone to the bottom-side of my penis, or the urethra, as I know it. It caused a slight dismfort, but no amount of real "pain".
About 10 minutes later, I noticed that my condom was filled with blood - from the inside. I had not yet ejaculated. I thought perhaps that I had torn the mouth, or tip, or of my urethra from forceful activity. But, when I removed the condom and cleaned the blood, there was no visible external injury.
I pressed the underside of my penis, from the scrotum upward, and dark richly red blood emerged from within. I continued doing this until the bleeding stopped. In total, about 5 to 6 big drops emerged. I could tell that the injury is located about 2 inches above my scrotum -- the blood doesn't come up unless I go down that far.
I felt no pain...and after about 15 minutes, I resumed the sexual activity and felt no pain after ejaculating. Although, there was still some blood found within the ejaculate.
During the past two days, and I'm still finding remnants of blood when I urinate - my urine is darker, almost a light brown, with an occasional piece of coagulated blood. I feel a slight burn from within the urethra in my penis, and it feels bruised when I apply pressure to that underside.
This morning I awoke with an erection, and it began bleeding again.
My first thought was that the penis is full of blood vessels, and I may well have popped a vessel. But, now I'm curious if the blood should be coming out through the urethra at all?
Moreover, I'm concerned that if the urethra has an open wound from within, would my own urine possibly cause an infection?
Thank you for your time and insight...
-Fred
Answer Fred, it is possible that you injured your urethra but much more likely is that the bleeding is coming from the prostate gland. Blood in the semen is called hematospermia. It is due to a tear in one of the fragile veins of the prostate gland. The prostate is the organ that produces the majority of the seminal fluid in response to sexual stimulation. Irritation of the gland (prostatitis) can cause it to become inflamed and predisposed to bleed. Some factors leading to inflammation include too frequent or too infrequent ejaculation, sexual arousal without ejaculation, withdraw at the time of ejaculation, excessive alcohol or spicy foods, prolonged sitting or bike riding, etc. The prostate may then become secondarily infected and require antibiotic therapy for cure. When the prostate contracts at the time of ejaculation, a vein may tear and blood mixes with the semen. Red blood indicates new and dark discoloration indicates previous bleeding. Hematospermia may at times be associated with gross blood dripping from the penis or during urination. This typically will occur with initiation or at the end of urination (as opposed to being throughout the entire stream). Sometimes as the prostate gradually enlarges with age, friable veins called varices develop on its surface. These are also prone to tearing. In such cases, Proscar is sometimes prescribed to shrink both the prostate and the veins. Hematospermia is not a typical sign of prostate cancer. If the bleeding is due to a urethral injury, these usually heal on their own. For the present, you should refrain from both sexual arousal and ejacultion. I suggest that you check with a urologist to be sure nothing more is going on. Good luck!
