This guideline covers the diagnosis and management of Haematospermia (blood seen within the ejaculate)

Haematospermia has a high chance of being a benign disease, albeit distressing and concerning.

Out of scope


Red Flags

Exclude haematuria

Exclude other inguino-scrotal abnormality (e.g. scrotal mass)


Prostate-specific antigen (PSA)

Rectal examination (PR)

Scrotal examination

There is no evidence of the value of additional urological tests that may include renal ultrasound scan (USS), trans-rectal USS, cystoscopy, these are rarely undertaken.


  • Sexually transmitted infections (STIs) and
  • Bleeding diathesis
Reassure and do not refer if:
  • PSA is normal and
  • Patient is less than 45 years old and
  • Symptoms settles within 6 weeks


Referral Criteria

Consider referral in patients:

  • Over 45 years old and
  • Persisting episodes, more than 3
  • Abnormal PSA

Referral Instructions

e-Referral service selection:

  • Specialty: Urology
  • Clinic Type: Not otherwise specified
  • Service: DRSS-South Devon & Torbay-Urology - Devon CCG - 15N

Referral Forms

DRSS referral form

Torbay and South Devon seeking advice form

Supporting Information

Pathway Group

This guideline has been signed off by South Devon and Torbay CCG

Publication date: October 2017


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