Hemospermia means blood in the ejaculate. Patients are often worried, but it’s usually harmless. Men sometimes confused hematuria or blood of a sexual partner with Hematospermie. Pathophysiology ejaculate consists of sperm from the distal epididymis and fluid from the seminal vesicles, prostate, Cowper’s and bulbourethral glands. Thus could introduce into the seminal fluid, a lesion somewhere along the path of blood. Etiology Most cases of Hämatospermie are idiopathic and benign Such cases heal spontaneously within a few days to a few months. The most common known cause is a prostate biopsy Among the less common causes include other instrumentation, a benign prostatic hyperplasia, infections (eg. As prostatitis, urethritis, epididymitis) and prostate cancer (in men> 35 to 40 years). Occasionally, tumors of the seminal vesicles and testicles are connected to Hämatospermie. Hemangiomas of the prostatic urethra or the vas deferens can lead to a massive Hämatospermie. (And to a lesser extent in India and parts of the Middle East), from entering the urinary tract, and hematuria and often cause Schistosoma haematobium, a parasitic fluke that causes serious diseases in Africa Hämatospermie. Schistosomiasis should only be considered in men considered that have been in areas where the disease is endemic. TB is also a rare cause of Hematospermie. Assessment history In the history of the present illness, the duration of symptoms should be considered. Patients who voluntarily provide any information should be specifically asked about a recent prostate biopsy. Important Accompanying symptoms include hematuria, difficulty starting or stopping urine flow, nocturia, burning during urination and penile discharge. The Zusammenhangt with sexual activity should also be requested. In an examination of the organ systems of the causative disease should be looked for symptoms including slight bruising, frequent nosebleeds and excessive bleeding gums when brushing your teeth or dental treatments (hermatologische disease) and fever, chills, night sweats, bone pain or weight loss (prostate infection or cancer). With a history of risk factors for sexually transmitted diseases (STDs-z. B. unprotected intercourse, multiple sexual partners), known bleeding disorders and well-known diseases to should be compared with specially by known diseases of the prostate, of past TB or HIV infection or exposure thereof, bleeding predispose (z. B. cirrhosis) are asked. When the drug history, use of anticoagulants or antiplatelet agents should be considered. Patients should look for cases of prostate cancer in the family history, and after traveling to regions where schistosomiasis is endemic, asked werden.Körperliche study the external genitalia should be inspected and scanned for signs of inflammation (erythema, mass, sensitivity), particularly along the course of the epididymis. A digital rectal exam is performed to the prostate enlargement, tenderness, or a node towards untersuchen.Warnzeichen The following results are of particular importance: take symptoms for> 1 month Palpable lesion along the epididymis or prostate trip to a region where schistosomiasis is widespread systemic symptoms (eg. as fever, weight loss, night sweats) interpretation of the results patients whose symptoms are a result of a prostate biopsy can be sure that the Hämatospermie is harmless and will go away. Healthy, young patients with a short duration Hämatospermie, an otherwise normal history and physical examination and no previous travel, likely to have an idiopathic disease. Patients with abnormal findings in prostate exam can prostate cancer, benign prostatic hyperplasia or prostatitis have. Urethral discharge suggests an STD. Sensitivity of the epididymis suggests a STD or a rare TB (rather in patients with risk factors for exposure, or are immunocompromised) close. Characteristic findings of a bleeding disorder or use of drugs that can increase the risk of bleeding suggests a triggering cause, but include no underlying disease aus.Tests In most cases, especially in men <35 to 40 years, a Hämatospermie is almost always benign. If no significant abnormality on physical examination (including digital rectal examination) is detected, a urinalysis, urine culture and STD tests are done, but there are no further investigation is necessary. Among the patients who could have a serious underlying disease and should be investigated include those with one longer duration of symptoms (> 1 month) hematuria obstructive urinary symptoms abnormal examination findings fever, weight loss or night sweats These results are of particular importance in men> 40 years. Tests include urinalysis, Urinkultur-, prostate-specific antigen test (PSA) and transrectal ultrasonography (TRUS). Occasionally, MRI and cystoscopy are needed. A seed investigation and analysis is rarely performed, but it can be useful if the travel history suggests a possible exposure to S. haematobium. Therapy Treatment depends, if known, for the cause. For almost all patients the assurance that hemospermia is not a sign of cancer and sexual function is not impaired, the only necessary intervention. If prostatitis is suspected, it can be treated with trimethoprim / sulfamethoxazole or a fluoroquinolone for 4-6 weeks. Summary Most cases are idiopathic or follow a prostate biopsy. Tests are ongoing symptoms or abnormal findings on examination required especially for patients with long. Schistosomiasis should be considered in patients who have traveled to endemic areas.