Many people panic when they find that their semen is red, which is medically called hematospermia. Hematospermia is a less common disease of the male reproductive system. It manifests as reddish semen. Men don’t have to panic when encountering this. Hematospermia is not a warning sign of disaster, but it cannot be ignored, because hematospermia may also be Caused by some serious diseases.
First, let's first understand the anatomy of the seminal vesicles and the composition of semen.
Seminal vesicles (seminal vesicles), also known as seminal vesicle glands, are a pair of long oval cyst-like bodies, about 10.0-15.0cm in length and 1.0-2.Ocm in width. It is located at the back and upper part of the base of the prostate, outside the ampulla of the vas deferens, between the bottom of the bladder and the rectum. The seminal vesicles are mainly composed of small tortuous tubules, with uneven surface, hook-loop shape, pocket-like or diverticulum-like tubular structure in the cut surface, high and thin mucosal folds, multiple branches and connected into a network. The upper part of the free and enlarged part of the seminal vesicle is the base of the seminal vesicle gland; the lower end is small, which is the excretion tube of the seminal vesicle gland.
In addition to the very small sperm, 60% of the composition of semen comes from the seminal vesicles and 40% comes from the prostate. But the prostate gland is hard and hard to bleed, and the seminal vesicle gland wall is very thin, once the inflammation is congested, it is easy to bleed. Therefore, the most common cause of blood sperm is seminal vesiculitis. It can also cause inflammation, swelling, congestion and bleeding of the seminal vesicle gland wall due to the spread of inflammation in adjacent organs. Blood sperm can be divided into functional and organic. Functional blood sperm is the contraction when men reach orgasm and the variable relaxation after ejaculation, which makes the pressure of the seminal vesicle glands change rapidly, and the capillaries on the cyst wall are damaged, causing bleeding or capillary permeability changes. blood. Organic blood sperm is caused by certain diseases. Common causes include:
Reproductive system infection is the most common cause of blood sperm. The pathogens of infection include viruses, bacteria, tuberculosis and parasite infections, and can also be the result of trauma, foreign bodies in the urethra, and chemicals. Common are seminal vesiculitis, prostatitis, posterior urethritis, seminal vesicle tuberculosis, epididymal orchitis and so on. Stones in the prostate, seminal vesicles or vas deferens can also cause blood sperm.
2. Obstruction or cyst
After ejaculatory duct obstruction, the obstructed proximal duct can be dilated and swelled, causing mucosal blood vessels to rupture and bleeding. Commonly include seminal vesicle cyst, ejaculatory duct cyst, seminal vesicle diverticulum, meridian non-tubular cyst, and prostate cyst.
A variety of benign tumors of the urogenital tract can cause blood sperm, such as posterior urethral adenomas, leiomyomas, fibroids, adenomatous polyps and prostate hyperplasia. Malignant tumors of the bladder, prostate, testes and seminal vesicles can also cause blood sperm.
4. Vascular abnormalities
Varicose veins in the seminal vesicles, prostatic urethra and bladder neck are the causes of blood sperm. In addition, abnormal blood vessels in the reproductive system can lead to blood sperm, including pelvic arteriovenous malformations, prostate hemangioma, seminal vesicles and spermatic hemangioma.
Mostly iatrogenic factors, common in prostate biopsy, intra-prostatic drug injection, prostate cancer radiotherapy, transurethral instrument operation or pelvic surgery caused seminal vesicle damage, vasectomy, distal ureteral stones after extracorporeal shock wave lithotripsy, hemorrhoid injection Wait after treatment. In addition, it is still seen in perineal trauma, gonadal trauma, and pelvic fractures.
6. Systemic factors
Hypertension, blood diseases (lymphoma, thrombocytopenia, leukemia, hemophilia), and anticoagulant abnormalities secondary to liver diseases can cause blood sperm.
The harm of blood sperm
1. Prevent sperm from killing sperm
During inflammation, because there are a large number of cells and white blood cells in the seminal plasma, it may also be mixed with pus, the viscosity will increase significantly, the ejaculated semen is not easy to liquefy, and the sperm cannot move and cannot drive straight into the cervix. The volume of seminal plasma during inflammation is too small, which is not conducive to sperm survival.
2. Blockage of the vas deferens causes infertility
Due to the complex structure of the sex organs that cause blood sperm and poor drainage, it is easy to become chronic, causing secondary obstruction of the vas deferens and obstruction of the ejaculatory duct orifice, resulting in dry ejaculation with only ejaculation but no semen discharge. This is the mechanism by which blood sperm causes infertility. Other causes of infertility include changes in seminal plasma composition during seminal vesicle adenitis. Bacteria swallow the nutrients in seminal plasma, compete for oxygen, expel toxins and metabolites, which undoubtedly make sperm face extremely unfavorable environment and decrease fertility.
3. Prolonged treatment leads to decreased sexual function
For functional blood sperm, idiopathic blood sperm and iatrogenic blood sperm, mainly symptomatic treatments such as hemostasis, suspension of sexual intercourse, prevention of infection, etc., and some patients often heal themselves.
If it is caused by infection, drugs and symptomatic treatment are available, combined with antibiotics and finasteride therapy is an effective way to treat infectious hemospermia. A small number of tuberculosis patients can be treated with surgery when necessary.
Intractable repetitive hematospermia can be used transurethral ureteroscopy or seminal vesicle irrigation according to the situation, ultrasound guided perineal or transabdominal seminal puncture catheter irrigation.
Posterior urethral polyps, adenomas, vascular disease and other urethral diseases that cause hematospermia can be cured by transurethral resection or electrocautery, while bladder cancer, prostate cancer, and seminal vesicle cancer require surgical treatment.