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Why is the semen not normal after a urinary tract infection?

The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

Dr. Vinodhini J.

Published At December 28, 2020
Reviewed AtJune 7, 2024

Patient's Query

Hello doctor,

I had a UTI with the usual fever, before five months. Before the UTI episode, my ejaculate was the usual (white), but my ejaculate has been clear ever since. I do not have pain, no problem with erections, plenty of desire, etc. What is the cause?

Thank you.

Hi,

Welcome to icliniq.com.

Ejaculate color and consistency depends on the frequency of ejaculation. If it is more frequent, it is more clear, light, and more transparent, that is normal and requires no treatment. The only concern here will be if you are looking for fertility, then I will follow up with you with semen analysis, but if not no need for the test. Reduction in the amount of ejaculate will be due to medication used to reduce enlarged prostate symptoms. So if you are on medications for prostate, you expect less ejaculate, and that is normal. After 50 years, the prostate starts to grow up and can (not in all patients) cause blockage to urine. Prostate cancer screening test starts after 50 years; therefore, please follow up with serum PSA (prostate-specific antigen) as soon as possible. On follow up, please let me know if you have symptoms like a poor flow of urine, increased frequency, difficulty to start passing urine, incomplete emptying of the bladder, straining, or increased frequency of waking up at night to pass urine.

I hope this helps.

Regards.

Patient's Query

Hi doctor.

Thank you for your answer. Your answer matches what my urologist says as well. I guess I will have to get used to the new look and should be happy that at 62, I can still have a good sex life.

Thank you.

Hi,

Welcome back to icliniq.com.

It is not an issue to have changes in the consistency of ejaculation. Even younger people have it. Nothing serious about it. In case of any help, please get back to me.

Thank you.

Patient's Query

Hi doctor,

I am interested in your viewpoint. About 10 years ago (at 50), I had a high PSA of 5 ng/mL and did a biopsy, which was negative. Three years back, my PSA was 10.5 ng/mL After four months in the same year, my PSA was 9.5 ng/mL Three years ago, I had an MRI with no conclusive cancer detection, although the radiologist highlighted an undefined area. I also had an MRI-guided biopsy, and it was again negative. Two years ago, my PSA was 10.5 ng/mL and now comes at 12.9 ng/mL (23 percent increase). My Ejaculate is clear, and no bleeding is present.

Thank you.

Hi,

Welcome back to icliniq.com.

Raised prostate-specific antigen (PSA) can be caused by many factors like inflammation of the prostate or infection, examination or instrumentation, ejaculation even by riding a bicycle, and cancer. In my opinion, follow up with prostate-specific antigen (PSA) once a year. If it remains in the same range, it is fine, but if it goes higher, go for a biopsy. I have a few patients who have been followed for many years with PSA, and their PSA is stable, like that range, and nothing was done.

Thank you.

Patient's Query

Hi doctor,

Does a 10.5 to 12.9 ng/mL PSA level increase fall within an acceptable range?

Thank you.

Hi,

Welcome back to icliniq.com.

No, I look at a doubling, so if it is 20 ng/mL, then I consider it increased. Usually, patients get anxious with this type of high PSA, but I always say PSA is specific for the prostate, not prostate cancer. So do not panic. Just follow up on your PSA once a year. Many low-grade prostate cancers even do not need treatment.

Thank you.

Patient's Query

Hi doctor,

Thank you for your answer. I am seeing my urologist next week. Let’s see what he says.

Thank you.

Hi,

Welcome to icliniq.com.

It is good to consult with a urologist in person. Let me know If you have anything more to ask.

Thank you.

Patient's Query

Hi doctor,

Thank you for your prompt responses. I will keep you posted. Happy with the service. Thank you.

Hi,

Welcome back to icliniq.com.

My pleasure that I helped you.

Thank you.

Patient's Query

Hi doctor,

I have another follow-up question.

Could there be a connection between the UTI I had in the past and the clear ejaculate ever since that episode and the current elevated PSA? I have read about low-grade inflammation of the prostate.

Thank you.

Hi,

Welcome back to icliniq.com.

It has been too long for urinary tract infections to be causing an increase in prostate-specific antigens. Prostatitis can cause an elevation in PSA, but prostatitis can be seen in the biopsy.

Thank you.

Patient's Query

Hi doctor,

Thank you, doctor, for your reply.

I have not had a biopsy since 12 months ago. I perhaps thought that a low-grade inflammation could cause elevated PSA. I guess I am obsessing too much over this.

Thank you.

Hi,

Welcome to icliniq.com.

The most common cause of elevated PSA with negative biopsy is prostatitis, and a slight rise now may be caused by prostatitis. That is why for further biopsy, I look for doubling of PSA.

Thank you.

Patient's Query

Hi doctor,

Thank you for your answer.

Hi,

Welcome back to icliniq.com.

In case of any help, I am here to help you.

Thank you.

Patient's Query

Hi doctor,

Are there any natural supplements that you would recommend?

Thank you.

Hi,

Welcome back to icliniq.com.

Antioxidants like vitamin E and Saw Palmetto. Low fat and a high-fiber diet can be preventive for prostate cancer.

Thank you.

Patient's Query

Hi doctor,

Thank you for your answer.

Hi,

Welcome back to icliniq.com.

In case of any help, I am here to help you.

Thank you.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Samer Sameer Juma Ali Altawil
Dr. Samer Sameer Juma Ali Altawil

Urology

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