How to manage hematospermia due to seminal vesicle stones?
Patient's Query
Hi doctor,
I had been having a few bouts of hematospermia and went to see a urologist. After an ultrasound and rectal examination, he said I have a small stone in my seminal vesicle. He told me that as long as I do not have prolonged bleeding or any pain, it is just something that I have to live with. My question is, should I be concerned any further at all? Everything else is perfect, blood, etc., PSA normal, prostate digital exam normal.
Hi,
Welcome to cliniq.com.
Thanks for consulting with us. The causes of hematospermia are inflammatory and benign like prostatitis, inflammation of seminal vesicles, inflammation of ejaculatory ductus, prostatic cysts or prostatic calcification or stone. Other causes are malignant, like cancers. Since you have been diagnosed with prostatic stone and do not have urinary complaints, better as your urologist advised to leave it alone as stone removal involves surgery, which is not required. It is not risky to leave the stone in the prostate. If the prostate grows bigger or stone grows bigger, causing you to have urinary symptoms, then you can go for turp and removal of stone as well. Therefore at this time, observation is better. If you have any more queries, please do not hesitate to ask me again.
I hope these suggestions are helpful.
Take care, and feel free to reach out if you need further guidance.
Thank you.
Kind regards.
Patient's Query
Hi,
Thanks for your prompt reply.
A small stone is in the seminal vesicle, and apart from that bout of hematospermia, there are no other symptoms or pain. Can I ask, would the stone enlarge over time or more than likely to remain as it is?
Hi,
Welcome back to icliniq.com.
Yes, the stone can enlarge, and there is no treatment to prevent that, but it can be very slow. Only follow-up is the only option. Measures on follow-up are size of stone and symptoms of hematospermia. The indication for surgery is severe hematospermia with clots or pain due to blockage and enlargement of seminal vesicles. An ultrasound every year is sufficient. Please keep updating me on ultrasound results when done. Be reassured that nothing to worry about and no need for intervention now.
Kind regards.
Patient's Query
Hi doctor,
Thank you once again for relieving my anxiety over this. So basically, I guess I have to expect intermittent bouts of hematospermia? If I wish that (with no other further symptoms), I can relax my anxiousness. Although I am 57 years of age, I regularly train everyday, run at least 10 miles per week, weights or circuits, etc. As my job is a coach for mainly boxing or kickboxing and always maintain a top level of fitness (sorry, I just wanted to give you a visual of my background, rather than a couch potato.
Hi,
Welcome back to icliniq.com.
Yes, keep fitness up and carry on that evergreen. You are still young; please keep on doing PSA every two years as a screening for prostate cancer rest of things are well. Do not worry about the mild on and off hematospermia as we know the reason; we worry initially and do work up to exclude cancers. As long as we know, it is only a stone. Everything will be fine.
My best regards.
Patient's Query
Hi doctor,
Thanks for your reply.
I will take your advice. It is weird how anxiety can control your head. It is shocking to see a red tinge in sperm, but I guess that is a normal reaction. It happened today, but the last time was over three months ago. Anyway, the main thing is I do not need to be concerned or anxious over it.
Same symptoms don't mean you have the same problem. Consult a doctor now!
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