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.

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

kookyburns1952 | @kookyburns1952 | Jul 13, 2024

In reply to @blainwin "How long after the prostate biopsy will I have rusty brown semen??" + (show)

The first ejaculation, not to worry. Mine bled at least 2 or 3 times.

pieperfarm | @pieperfarm | Jul 14, 2024

In reply to @blainwin "How long after the prostate biopsy will I have rusty brown semen??" + (show)

Can be several months depending on what type of blood vessals and arteries they hit, and how active your prostate is. You can imagine that bike riding, sexual activity, lifting weights, exercising, all will cause stress on your wounded prostate. Also most older men, especially those with prostate cancer have enlarged prostates. With no erection problems, my doctor put me on 10 mg Cialis, which is known to help with enlarged prostates. Cialis help my urine flow more than anything else I have tried. I have an MRI scheduled for September, and I will see if the volume of my prostate has reduced any.

jaemiami | @jaemiami | Feb 20 3:04pm

On February 4th, 2026, I had a prostate biopsy. After it was completed, I was told by the UR that I should expect to see blood either in my urine, feces, or semen. I had blood and one large clot in my urine for the rest of the day. No blood on feces. However, I had a lot of dark rust colored blood on semen. It was shocking at first but expected. As of today, the semen has turned the color of dark honey but in less quantity. Has anybody experienced this and for how long? It's gotten to the point that I am weary of ejaculating.

jayhall | @jayhall | Feb 20 3:36pm

I've had 2 biopsies and each time it took 8 weeks for the blood to clear from my semen. Drink lots of water and masturbate as much as you can it will help clear the blood out. If you have to have your prostate out you can still have an Orgasm but you will have dry orgasms. I miss ejaculating < sigh>