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Significant bleeding from penis. No pain.
Warning - This is pretty gross stuff.
I woke up this morning to somewhat bloody underwear. A few hours later, my underwear was pretty soaked in blood. When I investigated my underwear further, I saw a very small, membranous looking string of some sort. Very similar to when a woman menstruates.
I'm not experiencing any pain. This is not occurring during urination or ejaculation. I have not experienced an injury of any sort. No rough sex or any trauma. I did not feel or notice the bleeding taking place.
Something similar actually happened to me about 11 years ago when I was 24 (before I had health insurance - a very unhelpful doctor checked my colon, which was fine. no other tests).
I'll talk with my doctor tomorrow, but I'm curious if the community has any ideas. Most of what I see online does not really fit these specific symptoms (usually involves urination, trauma, pain, etc.).
Any ideas?
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it happened again today! Bright red blood - quite a spill, at the end of the flow while peeing. It looks like you are literally peeing blood. I forced it a bit at the end that's when the blood appeared.
Maybe you should read this article. It is a pretty rare condition called Urethral cavernous hemangioma causing gross hematuria. I wish I could help more!
https://bmcurol.biomedcentral.com/articles/10.1186/s12894-019-0441-0
@nmarc here is a more defined explanation with treatment options. Good luck and stop forcing yourself at the end of your stream. Doing so might be compressing the lesions forcing blood from them, if that is what you have. You should suggest it to your urologist.
“Urethral cavernous hemangiomas are rare benign vascular lesions of the urethra. There are no dedicated clinical guidelines or large series specifically addressing their presentation, diagnosis, or management in the provided Medical Knowledge Base. However, general principles for evaluation and treatment of urethral vascular lesions and analogous benign urethral swellings can be drawn from related conditions such as urethral caruncles and prolapse.
### **Clinical Presentation and Evaluation**
**Presentation**
– Patients may report painless or painful hematuria, urethral bleeding, or a protruding urethral mass.
– Lesions are often soft, compressible, and may blanch with applied pressure.
**Physical Examination**
– Inspection may reveal a red to bluish, raised lesion at or near the urethral meatus.
– Differentiation from urethral caruncle (pink, fleshy, postmenopausal) and prolapse (circumferential, doughnut-shaped) is essential [[1]](https://emedicine.medscape.com/article/443099-clinical), [[2]](https://emedicine.medscape.com/article/443165-overview).
**Imaging and Endoscopy**
– **Ultrasound**: May show a hypoechoic or isoechoic lesion with rich blood-flow signals; calcifications or cystic areas are less common than in caruncles [[3]](https://emedicine.medscape.com/article/443099-workup).
– **Cystourethroscopy**: Direct visualization helps exclude malignancy and confirms vascular nature of the lesion.
### **Management Approaches**
**Conservative Measures**
– Sitz baths and local care may relieve discomfort but are unlikely to resolve established vascular tumors.
– Topical estrogen or anti-inflammatory agents are not indicated for hemangiomas but are standard for urethral caruncles [[4]](https://emedicine.medscape.com/article/443099-treatment).
**Surgical and Interventional Options**
– **Excisional biopsy**: Recommended both to establish a definitive histologic diagnosis and to remove the lesion, especially if bleeding is recurrent or the diagnosis is uncertain. Indications mirror those for caruncles: atypical appearance, growth over time, failure of conservative therapy, or patient preference [[5]](https://emedicine.medscape.com/article/443099-overview).
– **Laser ablation or sclerotherapy**: Used in other anogenital hemangiomas but not specifically studied in the urethra.
– **Hemostatic measures**: Preoperative planning should include strategies for vascular control (e.g., electrocautery, topical hemostatic agents).
### **Histopathology**
– Cavernous hemangiomas consist of large, dilated vascular spaces lined by a single layer of endothelium, often with minimal supporting stroma.
– Histologic confirmation differentiates them from fibrovascular stroma seen in prolapse and caruncles [[6]](https://emedicine.medscape.com/article/443165-workup).
### **Postoperative Follow-up**
– Monitor for recurrence of bleeding or lesion regrowth.
– Uroflowmetry and symptom assessment to ensure no development of urethral stricture.
### Conclusion
Based on clinical references for benign urethral lesions, evaluation of a suspected urethral cavernous hemangioma should include thorough inspection, imaging (ultrasound), and cystourethroscopy to exclude malignancy and confirm vascularity. Excisional biopsy remains the mainstay both diagnostic and therapeutic approach, paralleling management principles for urethral caruncles and prolapse. Research evidence specific to urethral cavernous hemangiomas is lacking in the provided Medical Knowledge Base; thus, management is extrapolated from analogous urethral lesions.”
Thank you @jenatsky for this. Much appreciated! I have a visit scheduled with my urologist for November. I will update everyone on my findings.
@bill5letsfixthis
Did did you have hematospermia?
@bill5letsfixthis no, not a prostate issue. I had an embolization a few months ago on an AVM that was suspected as the cause but it did not resolve the issue. Still dealing with it.
@howardsentell
Sorry, just saw this. No, not at all
@idiopath
Took me and urologist a little time to figure it out. Wasn’t until I had a cystoscope where it was suspected and PAE resolved it. Good luck, Hope yours is resolved soon.