Blood in Semen after Prostate Biopsy

Posted by tinker @tinker, Mar 16, 2021

I couldn't find an existing thread on this topic, but I wanted to share what I'm seeing so far, and compare with other's results.

I'm 58 years old. After discovering a 5+ PSA result in a routine adult physical, I was scheduled for and received both a MRI, and a Transperineal biopsy. In my case, they took 16 samples. I do not yet have the pathology results.

I was told there could possibly be some blood in my urine, but to watch for clotting, etc and large amounts. I was also told there would likely be some blood in my ejaculate, tapering off over time. I understand the amount of blood can be influenced by number and location of samples.

I was not prepared for what happened though. Four days after the biopsy, and to my horror, I found my expectations were way underestimated. It was not "streaks or spots" of blood, nor was it red-tinted. It looked to be pure blood. The volume was probably double what I would have expected. Hoping that the next day would be more normal, I again tested the waters.. It was nearly as bad, however, the color seemed to be a cross between pure blood and fresh motor oil.

I've got a message into my care team, and I'm awaiting a response while I also await pathology. I'm a bit nervous.

Has this been other's experience? If it is common, why understate it in the publications I was provided?

I have not noticed blood in my urine, however, it tends to be dark-ish as I tend to under-hydrate.

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@cam77254

Good news. Everything appears to be clear of blood today. Thanks for pointing me to the VA website which said 2 months. This week is 8 weeks since my biopsy.
Thanks again to all for the info and encouragement.

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That’s great news!

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@cam77254

Thanks for the response John. I will probably wait a couple more weeks and just keep an eye on it. Like I said it seems to be less and less rust color each time. And yes, my doctor's office does have a patient portal where I can ask a question. I just feel like I am still getting over it. I have no other strange feelings or discomfort so hopefully it will all clear up soon.
I do have enlarged prostate which I take tamsulosin for. But I was on that before the procedure.
This all started when my PSA doubled this year. I had covid back in October 2022 and still keep wondering if that had something to do with the spike in PSA. I had the first PSA test in December 2022 and then again in January 2023 and it had not gone back down. Hence the reason for the biopsy. Doctor said they did not have enough information yet to know whether covid might affect the PSA numbers.

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I had COVID in December 2021. The night I got it I had chills and woke up to urinate 9 times during that night. A month later, I started having urine issues (weak stream, etc). Went to the Dr. on March and PSA was 7.5. I then went to Urologist and PSA came back down to 6.5. My wife and I decided for biopsy at that time. Thank God benign results. Continue with PSA test and is coming back up to 7. MRI at this time. No lesions found anywhere. New PSA test and now is 8. Going for another MRI next Friday.

All this to comment also on COVID. Although some research suggested there are no effects on prostate from COVID. https://www.nature.com/articles/s41391-022-00542-5

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@ralanis

I had COVID in December 2021. The night I got it I had chills and woke up to urinate 9 times during that night. A month later, I started having urine issues (weak stream, etc). Went to the Dr. on March and PSA was 7.5. I then went to Urologist and PSA came back down to 6.5. My wife and I decided for biopsy at that time. Thank God benign results. Continue with PSA test and is coming back up to 7. MRI at this time. No lesions found anywhere. New PSA test and now is 8. Going for another MRI next Friday.

All this to comment also on COVID. Although some research suggested there are no effects on prostate from COVID. https://www.nature.com/articles/s41391-022-00542-5

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I will be very interested to know what you find out from the MRI. I also had covid in October 2022. I went to my PC doctor in December and that is when my PSA came back high. 6.8. It had always been around 3.5 - 3.8. So he scheduled me with my Urologist which did the PSA test again and this time it was 6.9. I asked him at the time if covid could have any contributing factors to it being high and he said that he just didn't know, that there had not been enough research at the time to provide adequate data. But then I had the biopsy and like you, all came back benign. I am scheduled for a follow up with the Urologist in September and I know that he will check the PSA again. I am praying that it is down by then. He said at the time of the biopsy since it was negative that I probably would not have to have anything else done. Don't know if that includes not recommending an MRI.

I had a UTI about a month after the biopsy and was on an antibiotic to clear that up. Everything has been pretty good since then. I do take Tamsulosin and that has really helped me. I doubled up on it during the UTI because I was having such a hard time going. I have gone back to just one a day now and so far that is working good. Still having a good stream and rarely getting up in the night to go.

Thanks for the article and I guess it is probably still the same, they don't have enough data to know for sure if covid is actually causing issues with the prostate. Hopefully they will keep studying it and find out.

I also am sending you a private message if we could discuss this more. Thanks again for all the helpful and wishing you the best from the MRI and good results. Please let me know how your MRI comes out.

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@cam77254

I had a prostate biopsy 7 weeks ago. Everything came back benign. Had a little blood in urine for a day or so and that has cleared up. My question is I still see some rust color in semen, not bright red. I had read that could be expected for up to 6 weeks but I am 7 weeks now and still see it. I don't think as much as I did at first. Should I be concerned or does it take time for all the old blood to get cleared out of the prostate?

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Thanks, First MRI was in January and no lesion was found. Urologist said that he cannot give me a score of something that doesn't exist. I was happy and waited to now May for another PSA test. Came back higher than January test (7 to 8). Dr. made me choose between biopsy or MRI: after first biopsy last year, I rather have another less invasive MRI. I will let you know the results in a couple of weeks.

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I had a Transperineal Biopsy where 12 samples were taken on March 6, 2023. My first "test of my plumbing" a month later revealed rust colored blood in the semen. Then the same test was done on May 29, 2023 where there seemed to be a little less blood present. That's roughly 12 weeks ! From what I've read on the Net the more tissue biopsies that are taken, one can expect this condition to last longer. This is due to the fact that one or some of the blood vessels in the prostate will get slightly damaged during the biopsy procedure. NOTE: drinking large amounts of water each day to "flush things out" is nonsense. Gee, I wonder if a blood transfusion might be more appropriate in this situation !!

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@murray1949

Had a biopsy 8-18-22 and 15 samples, how long should I expect blood when I have sex?

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My 12 TP biopsies were on March 6, 2023 and am still seeing some rust colored blood in semen on May 29th. Did your doctor say when a patient should contact them if blood is still appearing after a certain number of weeks?

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A year ago, I had my first biopsy. After a few days, I got horny and pleasured myself. Just like everyone else, I got a shockingly disturbing visual of blood. MY DOCTOR NEVER MENTIONED this apparent side effect. I can only imagine the HORROR had I been intimate with my wife instead, (insert your preferred scenario).
I regained my composure after nearly passing out and got online to figure out what's up. I was happy to see that it was common and no need to worry. It cleared up a few weeks (or a few performances) later.

So now I just had another biopsy and MY QUESTION is: Is the clearing up process a "TIME" factor (3-4 weeks) or a "FLUSHING" factor (3-4 ejaculations) or both? I want to know if I go a month without sex, then will I have a clean (or almost clean) ejaculate? Will my body absorb, filter and clean my seman? Or will I still have to flush it out either way?

Seriously, this needs to be studied, graphed, published and mandatory for doctors to thoroughly explain the bloody expectations.

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Shocking when you first see it but it is a really common side effect that usually diminishes over time. That is usually less than a month.

I would think that almost everyone has blood in their semen after a biopsy for at least a week or two. Has anyone here been the exception?

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I certainly was no exception. I had it from biopsy, diminishing over time, but there, until removal a few months later,

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I was also told to expect what you were told to expect. In my case I did not experience blood in my urine. I did have blood just one day in my urine.

I experienced something else.
I thought I would take the biopsy , scheduled for 9 am, and then go to work.
Just after the biopsy (12 samples) on my way to the hospital parking lot, I started feeling weak. So I went home instead and straight to bed.

That was the beginning of a week long bedrest. I experienced constant diarea, gas, goosebumps, weakness, headache etc.

So I guess everyone has a difference experience. Some better then indicated by the professionals, some worst then indicated by them.

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