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-Western-Urology-Devon CCG-15N

Referral Forms

DRSS referral form

Supporting Information

Pathway Group

This guideline has been signed off by the Western Locality on behalf of NEW Devon CCG.

Publication date: December 2016


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