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Date of last update: 8/13/2017.

Forum Name: Urology Topics

Question: Bleeding from penis when erect, no other symptoms.

 emtinoklahoma - Thu Jan 01, 2009 5:37 am

2 weeks ago, after sex with my wife, i urinated bright red blood and clots. I went to the ER and was told I had microscopic blood in urine, and check with PCP. 2 days later PCP said all looked well, no blood in sample at all. 4 days ago, had sex again, same result. 2 days ago, when penis is erect, I bleed. The amount is enough for dripping, and it seems to "backflow" to my bladder. I then have to urinate, it is bright red, then all is well. I do not have urination problems. No volume problems, no frequency issues, stopping and starting normal. No significant history. When I called my PCP back and told him what was going on, he recommended that I see a urologist. Any idea what could be causing this??
 Dr.M.Aroon kamath - Sat Oct 17, 2009 11:28 pm

User avatar Hi,
The fact that you feel that the bleeding "seems to "backflow" to my bladder", suggests that the bleeding must be closer to the prostatic urethra than the distal urethra (near the tip).
A number of causes for post-coital urethral bleeding in males have been reported in the medical literature.
Some of them are...
- minor coital trauma
- vascular malformations of urethra
- Benign prostatic hyperplasia
- penile piecing, etc.
In your case, it is better to begin by investigating for a bleeding source in your Prostate.Cheers!
 Melon1991 - Wed Dec 23, 2009 11:04 pm

HI i have a very similar problem but in my case i'm a 18yr old boy (virgin). Dark red Blood with clots seems to come out when i get the feeling of going to urine after prolonged erection. But once it happened exactly after mastrubation too. I visited a urologist and got a scan done but the report said everything was ok. I tried not to mastrubate after that. But Soon after a month or so, a mere thought of some pornographic images lead to a stiff erection and i could feel a vien burst near my penis(this is the only symptom before it happens) i immediately stopped and went to the toilet i found blood with many tiny clots coming out, i drank a lot of water and went to toilet (it was clear) but i had a sharp pain in the end Please help!!
 Dr.M.Aroon kamath - Tue Jul 27, 2010 2:41 pm

User avatar Hi Melon1991,

I wish to add a bit more details to what i already described in my reply to emtinoklahoma.

In this context one must try to understand a couple of often somewhat confusing terminologies.
- isolated hemospermia(is blood in the seminal fluid) and
- post ejaculation hematuria(also can be post-coital hematuria), which is bleeding per urethra following ejaculation. This may or may not be associated with hemospermia.

Isolated hemospermia is a more common clinical condition
and is often due to infections and inflammations(originating from conditions in the urethra, prostate and seminal vesicles) though in up to 40% of cases, the cause may be indeterminate.

Some of the reported causes of post-ejaculation hematuria are,
- Posterior urethral hemangiomas,
- large varicosities located at the apex of the prostate,
- varicosities in the posterior urethra,
- benign prostatic utricular papilloma,
- penile fracture with associated urethral injury,
- Isolated urethral rupture(rare),
- violent massage of the prostate is known to cause hematuria from the prostate and posterior urethra.

Thorough evaluation is necessary in cases of postcoital hematuria as treatable lesions can be identified. Cystourethroscopy following simulation of the circumstances of bleed (masturbation or coitus) may demonstrate the lesion. The other technique that has been used is cystoscopy during pharmacologically induced erection. Some of these causes may be dealt with eminently during cystoscopy
(by electrofulguration, or laser coagulation).

After thorough investigations, in cases without identifiable causes, the patients could be reassured that the condition is benign and likely to be self-limiting.

Obviously you need to consult a urologist to be investigated comprehensively.
Best wishes!

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