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Hi, I am an FNP in a family practice and I have just a few questions. I've had several patients come in with hemataspermia, middle aged men age 50-60, no past medical hx besides maybe a little HTN. They both had occasional bright red, to dark red ejaculations post coital with their spouse and with self stimulation to confirm the issue. Both patients also had not't had well exams for a number of years. Both patients also had pressure/discomfort in the scrotum that would be uncomfortably/painful. So my question is, when should I refer on to urology and what work-up do Urologists typically like to be done before the patient gets there? ie. lab work, imaging etc. And is Hemataspermia typically worrisome in the older adult male? Thanks! Sean
That is very reassuring! Thank you. What about microscopic hematuria in a similar age group? This seems to show up with some frequency and I cannot usually find a cause. They are not athletes, and no other reason I can find. They just have + microhematuria per UA and under the microscope. No other symptoms. I just don't want to miss something like bladder cancer. Does bladder cancer present with any other typical symptoms and what tests should I do or what type of things should I rule out before referring on for this (besides the obvious things like infection)? I have in the past erred on the side of letting the urologist order the Urogram as I don't want to unnecessarily expose the patient to radiation, but I also don't want to waste your time in the specialists office for every little microhematuria that comes in but yet persists