Blood Ejaculation

Blood ejaculation (XTM) is a common symptom in the form of ejaculation disorders and it makes the person feel very nervous, although the cause is rarely the result of a malignancy.
XTM is defined as having blood in semen, possibly semen with fresh blood fibers or dark brown mass of semen.
Causes When sperm is abnormal, people often think of some damage to the organs that produce it.
Causes of seminal vesicles:
- Vasculitis is the most common cause, possibly due to retrograde inflammation from urinary tract infections such as urethritis, cystitis, prostatitis (TTL). Therefore, the examination often exploits the history of urinary tract infection

.
- Tuberculous vesicular inflammation is also common, either primary or secondary, from an organ in the body.
Vesicles or ejaculatory follicles also cause XTM.

Causes from TTL: - Due to TTL biopsy, needle stick through the rectum to take a biopsy sample and damage the TTL, when ejaculation will cause bloody and mixed semen condition

- TTL inflammation (30% of cases)
- TTL cancer: cancerous growth and hemorrhage will cause XTM.



Thus, XTM can suggest TTL cancer and is a sign that helps us think of TTL cancer for timely diagnosis and treatment.
- TTL varicose veins can also cause XTM.
- TTL fibroids, prostate stones.
- TTL follicles, when there are follicles in the TTL burst, it may cause XTM. After TTL laparoscopic surgery or piezoelectric treatment to treat benign tumors, TTL.
Causes from the urethra:
- Urethritis also causes XTM, especially cystitis.
- Urethral cyst, urethral polype
- Injury of the urethra, trauma of the perineum.




In addition, testicular injury, after surgery for internal hemorrhoids, can cause XTM. Systemic diseases such as hypertension, coagulopathy, chronic liver disease, autoimmune disease can also cause XTM although the mechanism has not been clearly defined.
Diagnose
To diagnose XTM, it is necessary to ask whether the patient has a history of TTL biopsy, had any previous genital urinary tract infection?
Diseases of TTL and seminal vesicles, hypertension, TTL tuberculosis and seminal vesicles, TTL stones and seminal vesicles, bleeding site, TTL cancer, vesicular cancer and TTL varicose veins.
Diagnostic tests included
- General analysis and urine culture: helps to diagnose etiology that may be secondary to vesicular inflammation after cystitis or urethritis. If TB is suspected, a urine culture should be performed to find tubercle bacilli.
- Transplant culture and analysis of semen: the diagnosis identifies XTM, bacteria can be cultured as antibiotics to support the treatment.
- PSA for patients> 40 years old to rule out TTL cancer.
- Complete coagulation function for XTM patients over 2 months.




Means of visual learning
- Rectal ultrasound: giving clear images of seminal vesicles, ejaculating tubes can identify XTM causes such as cysts, seminal vesicles; TTL microscopy, may have images of seminal vesicle inflammation on ultrasound of the rectum.
- Magnetic resonance: helps diagnose bleeding from seminal vesicles or TTL.
- Cystoscopy: helps detect damage to the urethra and TTL, cystitis, bladder neck bleeding ...
Laparoscopy and vesicular biopsy when there are abnormalities on ultrasound or magnetic resonance.
Treatment
Medical treatment includes antibiotics in cases of genital urinary tract infections, vesicular inflammation, cystitis.
Antibiotics are often selected as antibiotics acting on the urinary tract such as quinolones, tetracycline groups .



.. In the case of non-responsive treatment, we can treat according to the results of semen culture and according to the antibiotic diagram..

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