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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@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

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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@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

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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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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@johnbishop

Welcome @cam77254, Like you, from what I've read the blood in the semen is expected or common but I'm not sure anyone knows for sure how long it may take before it's back to normal color. Here are just a couple of examples:

"It's common to notice red or rust coloring in your semen after a prostate biopsy. This indicates the presence of blood, and it's not a cause for concern. Blood in your semen may persist for a few weeks after the biopsy."
--- Prostate biopsy - Mayo Clinic: https://www.mayoclinic.org/tests-procedures/prostate-biopsy/about/pac-20384734

"You may see minor bleeding after the procedure. This is normal and often needs no treatment. You may see blood in your urine or semen (rust color). This may last for 1 to 2 months. You may also have light bleeding from your rectum if you have hemorrhoids. This can last up to 7 to 14 days."
--- Prostate Biopsy - Veterans Health Library: https://www.veteranshealthlibrary.va.gov/Encyclopedia/142,83022_VA.

I'm kind of the same when I have a procedure done and I have some of the symptoms they warn me about and they go a little longer than what the doctor mentioned would or might happen. I'm thinking if it were me, I might just give the doctor a quick call if for nothing else than to give me a little comfort knowing everything is probably OK.

Are you able to contact your doctor or care team, or send them a message on a patient portal to ask your question?

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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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@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?

Jump to this post

Welcome @cam77254, Like you, from what I've read the blood in the semen is expected or common but I'm not sure anyone knows for sure how long it may take before it's back to normal color. Here are just a couple of examples:

"It's common to notice red or rust coloring in your semen after a prostate biopsy. This indicates the presence of blood, and it's not a cause for concern. Blood in your semen may persist for a few weeks after the biopsy."
--- Prostate biopsy - Mayo Clinic: https://www.mayoclinic.org/tests-procedures/prostate-biopsy/about/pac-20384734

"You may see minor bleeding after the procedure. This is normal and often needs no treatment. You may see blood in your urine or semen (rust color). This may last for 1 to 2 months. You may also have light bleeding from your rectum if you have hemorrhoids. This can last up to 7 to 14 days."
--- Prostate Biopsy - Veterans Health Library: https://www.veteranshealthlibrary.va.gov/Encyclopedia/142,83022_VA.

I'm kind of the same when I have a procedure done and I have some of the symptoms they warn me about and they go a little longer than what the doctor mentioned would or might happen. I'm thinking if it were me, I might just give the doctor a quick call if for nothing else than to give me a little comfort knowing everything is probably OK.

Are you able to contact your doctor or care team, or send them a message on a patient portal to ask your question?

REPLY

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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@colleenyoung

@stebro, what did you find out from you doc? Any concern?

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I did talk to my doc. Totally normal. Blood in ejaculate longer than six weeks - probably should contact your doctor. Mine stopped in about three weeks. Blood in urine stopped in a few days. All good.

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@web265

At the risk of sounding like "Capt. Obvious", I went in with a list every time. I would have never remembered my questions without it. What would happen with me was I'd start to process the answers from the first question or two then forget to ask question four and five....

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Oh, I had a carefully compiled list. Like you, I always do. The problem was, I forgot to put it on the list.

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I just had a biopsy and I was fine day one, the next day I started to have some blood and clots in the urine, it cleared after two days. However, like you, while it wasn’t as much blood, but I experienced blood in my ejaculate, at first bright red, for a couple of times. Later, it started to show like you said motor oil, that went on for a week. It has cleared up, but you can see it still is a bit tinted.
I have since found out I’m positive, stage 1, Gleason 6/7. I’m now going thru additional testing. And so it begins.

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