hemospermia
Introduction
Introduction to blood syndrome Hemorrhagic disease is a common disease in the urology and male fields. That is to say, red semen is discharged during sexual life ejaculation and nocturnal emission. The normal semen is milky white, grayish white or light yellow. After the blood is fine, it is pink, brownish red or with bloodshot. Under the light microscope, it can be seen that the semen is mixed with red blood cells. The heavy one can see the blood in the essence. The most common cause of clinically elevated blood sperm is the seminal vesicle and prostate area disorders. The most common is seminal vesiculitis. The seminal vesicle is located above the prostate, between the bladder and the rectum. The end of the seminal vesicle merges with the end of the vas deferens to form an ejaculatory duct that passes through the prostate to the urethra. There is a tiny vascular network in the wall of the seminal vesicle, which contains many microvessels. When inflammation, tumors and tuberculosis occur in the surrounding organs, the inflammatory exudate will follow the tiny vascular network in the seminal vesicle wall layer, when the bacteria cause inflammation of the seminal vesicle. At the time, the wall of the seminal vesicle is swollen and congested, and the microvessels are easily broken and hemorrhage, and red semen appears when the sperm is discharged. basic knowledge Sickness ratio: 0.0001% Susceptible people: male Mode of infection: non-infectious Complications: Infertility
Cause
Cause of blood azoospermia
Inflammation (40%):
The seminal vesicle, prostate and urinary tract, rectum and other organs are closely adjacent, which is easy to cause infection. The inflammatory process after infection can stimulate the mucosa of the tubules and glands, causing local congestion, edema and bleeding. Infectious pathogens include viruses, bacteria, mycobacteria, and parasitic infections. Inflammation can also be the result of trauma, urinary tract foreign bodies, and chemicals. Trauma can include stones in the prostate or seminal vesicles.
Obstruction or cyst (30%):
After the ejaculatory duct obstruction, the proximal tubing of the obstruction can be dilated and expanded, resulting in rupture and bleeding of mucosal blood vessels, such as Wolffian, cysts, seminal vesicles, and prostate cysts.
Tumor (20%):
Various benign tumors have been reported to cause blood sperm, such as ectopic prostate tissue in the urethra, prostate polyps and proliferative urine can cause blood. Malignant tumors of the prostate, testis and seminal vesicles can cause blood.
Vascular abnormalities (10%):
The varicose veins of the seminal vesicle, prostatic urethra and bladder neck can also be the cause of blood sperm. In addition, vascular abnormalities in the reproductive system during adolescence can lead to blood sperm, including arteriovenous malformations, prostate hemangioma, seminal vesicles and rare spermatic hemangioma. .
Prevention
Hemophilia prevention
1, taboo sex after the disappearance of blood essence should still rest for 1-2 weeks after recovery, sexual life should not be too frequent.
2, taboo drinking and spicy spicy food to avoid aggravating congestion, do not ride long distance riding.
3, once a week, seminal vesicle prostate massage helps to discharge inflammatory secretions.
Complication
Hemorrhagic disease complications Complications, infertility
1, kill sperm
In the inflammation, because there are a lot of cells and a lot of white blood cells in the seminal plasma, it may also contain pus, the viscosity will increase significantly, the injected semen will not be easy to liquefy, the sperm can't move and can't drive straight into the cervix. The volume of seminal plasma is too small during inflammation, which is not conducive to sperm survival;
2, sexual dysfunction
If blood is not cured for a long time or the treatment is not ideal, it will lead to a decline in other parts of the body, as well as the fear of the disease in the heart, affecting male sexual function.
3, causing infertility
Due to the complicated structure of the sexual organs causing blood sperm, poor drainage, it is easy to turn chronic, which causes secondary vas deferens obstruction, ejaculation edema obstruction, resulting in dry ejaculation with only ejaculation action but no semen discharge.
Symptom
Symptoms of Hemorrhagic Disease Common Symptoms Blood Essence Urinary Urinary Frequency Abdominal Pain Urinary Pain Chill
1, blood essence has a light and heavy point.
The severe one can see the blood in the essence, called "the blood of the naked eye"; the lighter needs to use the microscope to find red blood cells in the semen, called "microscopic blood essence."
2, a large number of blood essence can be combined with acute urinary retention and a series of sexual dysfunction.
As for whether it affects fertility, it varies from person to person. Most blood sperm patients still have children, and some patients cause infertility.
3, blood essence is also anxious, chronic points.
Acute people often have chills, fever and other systemic symptoms; lower abdominal pain and frequent urination, urgency, dysuria and dysuria. Long-term can be converted to chronic, its sign is confused with chronic prostatitis, and often combined, but the naked eye or microscopic blood is a feature of seminal vesiculitis, it is not difficult to identify.
Examine
Blood syndrome examination
First, step by step ejaculation check.
For patients with blood essence, some hospitals will also require patients to do step-by-step ejaculation examination. Through blood test, not only can red blood cells and white blood cells be found in semen, but also the condition of accessory gonads and the source of blood essence can be estimated.
Second, semen bacteria culture + drug sensitivity test.
For some patients in need of semen bacterial culture + drug sensitivity test, the doctor can choose the appropriate antibacterial drugs.
Third, prostate examination.
The prostate is examined by the rectum for swelling, tenderness and nodules. It is worth noting that sometimes when the prostatic fluid is taken from the prostate, due to excessive force, red blood cells can also appear in the prostatic fluid. It cannot be said that the prostate must have lesions.
Fourth, regular examination of semen.
Learn about the presence or absence of white blood cells in the semen. If there are white blood cells, there is inflammation in the prostate and seminal vesicles. If the white blood cells exceed 20 per high field of vision, it is pus. Sometimes, because there are many red blood cells in the semen, it is difficult to distinguish white blood cells. After the blood sperm is stopped, the semen can be checked again. Sometimes the abstinence time is too long, the seminal vesicles are congested for a long time, and the white blood cells in the semen will also increase.
Five, seminal fluid examination.
After urination, massage the seminal vesicle and collect the seminal vesicle fluid. When the seminal vesicle is bleeding, the seminal fluid may have an old brown liquid. Inflammation of the seminal vesicle, leukocytosis in the seminal fluid.
Sixth, B-ultrasound inspection.
It is best to have color ultrasound to understand whether the seminal vesicle is swollen, cyst or stone.
Seven, cystoscopy.
Severe blood or recurrent blood can be used for cystoscopy. Mainly to observe the presence or absence of hypertrophy, urethral tract varicose veins and tumors.
Diagnosis
Diagnosis of blood syndrome
Diagnostic criteria
1 Ask about the medical history, especially the history of the genitourinary system.
2 The physical examination focuses on the reproductive system examination.
3 laboratory tests focus on prostate fluid, seminal fluid and semen examination.
4X-ray examination of pelvic dry film can rule out prostate stones, seminal vesicle stones, epididymal tuberculosis calcification, vas deferens semi-capsule angiography value, can clear the various lesions of seminal vesicles and vas deferens.
5 bladder urethroscopic examination can observe the inflammation of the posterior urethra, fine sputum, ejaculatory duct, and sometimes can be retrospectively retrospective.
