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Blood in semen after biopsy

User
Posted 23 Feb 2019 at 09:46

Hi there had a biopsy 10 days ago and decided to ejaculate after 5 days .was totally shocked at the amount  of blood that came out ,tryed again 2 days later same result. Can and give me a guide to how long this lasts for or does it go away with the more times you ejaculate .sorry for been so crued 

User
Posted 23 Feb 2019 at 09:46

Hi there had a biopsy 10 days ago and decided to ejaculate after 5 days .was totally shocked at the amount  of blood that came out ,tryed again 2 days later same result. Can and give me a guide to how long this lasts for or does it go away with the more times you ejaculate .sorry for been so crued 

User
Posted 23 Feb 2019 at 12:22
This is completely normal as your prostate which produces semen has been perforated by numerous needles. The more you ejaculate, the quicker the old blood will be expelled.

It can take up to six weeks to go from strawberry back to vanilla. Enjoy!

Cheers, John.

User
Posted 24 Feb 2019 at 11:46

Blood in semen lasted 3 weeks for me after transrectal biopsy (was told it could last up to 6 weeks, maybe if you don't try flushing it out as often as I did). Consultant said not to hold back ejeculating (might have been a hint it's a good thing, not sure). I did wait a day fearing it might be painful, but it wasn't.

First few days, it's bright red and quite horrific if you haven't been warned. If you are having sex with a partner, it might perhaps be polite to wear a condom, although (according to consultant) the blood is not harmful to a partner.

Then it turned rust coloured as the blood becomes stale (no fresh blood and the existing blood turns to different iron oxidation states which is same as rusty iron - just like a blood stain does as it ages).
It gradually faded back to normal after 3 weeks.

After transperineal biopsy, I held back 2 days before trying for an erection, given loads of needles had been pushed though base of penis, but again consultant said no need to hold back, and there was no effect caused by the needles when I did. By this stage I was on HT which reduces semen anyway. First time there was no blood, but subsequent times there was stale blood, although not as much as for the transrectal biospy. Again, took 3 weeks to clear, and it was always totally pain free.

Edited by member 24 Feb 2019 at 15:41  | Reason: Not specified

User
Posted 01 Sep 2020 at 08:34

EdwardSprin,

Don't worry. Sounds perfectly normal after a biopsy. It seemed like I was just ejaculating blood to begin with. Gradually changes colour over time. Think It was a good 2 weeks for me before it cleared up.

User
Posted 01 Sep 2020 at 09:39

If it looks like tomato ketchup, don't be surprised.

Yes, the leaflets they give you are way off. Mine said something like "there may be some blood in your semen for up to 6 weeks". Fortunately, I'd read forums beforehand, and knew what was possible.

I do one-to-one support of patients, and I've had 2 or 3 cases of men contacting me in sheer panic having ejaculated tomato ketchup just after a biopsy. The warnings beforehand (where they exist at all) are massively inadequate.

User
Posted 23 Feb 2019 at 12:34
Yep, completely normal. You should find that the colour changes from red to brown over time (ie it's dead blood rather than fresh blood) and it will gradually diminish. It'll probably take a month or so to completely disappear, though.

Absolutely nothing to worry about.

Chris

User
Posted 23 Feb 2019 at 20:17
Yes, nothing to worry about. I'm a few weeks ahead of you, having finished a course of radiation three weeks ago. I'm not suggesting you will need rt at all, many people don't! But one of the side effects was burning urination and painful ejaculation. I finally managed the latter this morning and was pleased that it wasn't as bad as I thought. By the way, you can ask what you like on this site and no one will think you are being crude. There are some very knowledgeable and helpful people out there. Have you got the biopsy results yet?
User
Posted 18 Jan 2021 at 21:32

I've had a couple of support line calls from guys who waited a couple of months before daring to ejaculate, and were horrified to find it was black. It's the iron from the hemoglobin which has broken down and literally gone rusty. Not anything to worry about, but it may be better to get it out than leave it in there.

I didn't manage to get it all out from my second biopsy - I was already on hormone therapy and no longer ejaculating much. When I had a full body MRI scan a few months later, there's a bright white dot showing in my prostate. I asked the radiologist if that was the cancer because I didn't think it showed up that clearly. He said no, it's iron oxide left from blood which the body failed to reabsorb, and because iron oxide is magnetic there was enough there to show up bright white on an MRI scan.

Edited by member 18 Jan 2021 at 21:33  | Reason: Not specified

User
Posted 11 Sep 2021 at 13:16

Depends how often you ejaculate.

Bright red suggests bleeding within last 3 days as the blood goes brown after about 3 days after bleeding, which in turn suggests you might still be bleeding.

There are some suggestions it's good to get it out. It took 3 weeks to go with daily ejaculation for me, but that was with no further bleeding after the biopsy.

User
Posted 11 Sep 2021 at 13:20

Mine got lighter as the weeks went by and had gone completely by 10 weeks. Though, unlike Andy62, I was not ejaculating daily

 

I am due to have a 30 core biopsy extraction on Thursday (16/09) so will experience the whole thing again

User
Posted 11 Sep 2021 at 13:31

Good luck with your next biopsy, I hope all will go well for you

User
Posted 15 Sep 2021 at 10:13

Most exercise is unlikely to be a problem. If you have a blood clotting disorder or you are taking blood thinners then more cautions is required. I think I would not do any cycling for quite a few days (perhaps a week, two if I were very cautious). Walking no big deal, Yoga: I wouldn't be doing the splits,  running maybe a few days, hurdling, high jump pole vault, maybe a bit longer. I can't imagine press-ups being a problem. 

 

Dave

User
Posted 19 Sep 2021 at 09:22

I have had 2 TP biopsies now (one on 04/06/21 and one on 16/09/21), with the first one being performed under a local anaesthetic and the second one under a general.

With regard to the first one, my urine was clear within 24 hours and my semen within about 10 weeks (though I did not ejaculate that often, hence the reason I think it took a while to clear). The paperwork I was given after my biopsy at Addenbrookes in Cambridge was that blood could be in the urine for up to a week and in the semen for up to 12 weeks. I did have a swelling around the area where the needles went in after about 4 days, and my testicles were a little tender too, but both cleared up a week or so after I first noticed the issue.

With regard to the second biopsy, I have detailed this on a post under my name but to save you searching this out will say this: I only had blood in my urine for a few hours after the procedure and 3 days after my semen is still blood red. I have, to date, had no pain or discomfort from the procedure.

Hopefully, others will come on and comment too, but if your testicles are still swollen after 10 days it might be worthwhile having a word with the doctor who undertook the biopsy to see what he thinks.

 

 

Edited by member 19 Sep 2021 at 09:29  | Reason: Not specified

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User
Posted 23 Feb 2019 at 12:22
This is completely normal as your prostate which produces semen has been perforated by numerous needles. The more you ejaculate, the quicker the old blood will be expelled.

It can take up to six weeks to go from strawberry back to vanilla. Enjoy!

Cheers, John.

User
Posted 23 Feb 2019 at 12:34
Yep, completely normal. You should find that the colour changes from red to brown over time (ie it's dead blood rather than fresh blood) and it will gradually diminish. It'll probably take a month or so to completely disappear, though.

Absolutely nothing to worry about.

Chris

User
Posted 23 Feb 2019 at 19:31

Thank you 

User
Posted 23 Feb 2019 at 20:17
Yes, nothing to worry about. I'm a few weeks ahead of you, having finished a course of radiation three weeks ago. I'm not suggesting you will need rt at all, many people don't! But one of the side effects was burning urination and painful ejaculation. I finally managed the latter this morning and was pleased that it wasn't as bad as I thought. By the way, you can ask what you like on this site and no one will think you are being crude. There are some very knowledgeable and helpful people out there. Have you got the biopsy results yet?
User
Posted 24 Feb 2019 at 07:31

Going Tuesday absolutely bricking it at the moment 

User
Posted 24 Feb 2019 at 11:46

Blood in semen lasted 3 weeks for me after transrectal biopsy (was told it could last up to 6 weeks, maybe if you don't try flushing it out as often as I did). Consultant said not to hold back ejeculating (might have been a hint it's a good thing, not sure). I did wait a day fearing it might be painful, but it wasn't.

First few days, it's bright red and quite horrific if you haven't been warned. If you are having sex with a partner, it might perhaps be polite to wear a condom, although (according to consultant) the blood is not harmful to a partner.

Then it turned rust coloured as the blood becomes stale (no fresh blood and the existing blood turns to different iron oxidation states which is same as rusty iron - just like a blood stain does as it ages).
It gradually faded back to normal after 3 weeks.

After transperineal biopsy, I held back 2 days before trying for an erection, given loads of needles had been pushed though base of penis, but again consultant said no need to hold back, and there was no effect caused by the needles when I did. By this stage I was on HT which reduces semen anyway. First time there was no blood, but subsequent times there was stale blood, although not as much as for the transrectal biospy. Again, took 3 weeks to clear, and it was always totally pain free.

Edited by member 24 Feb 2019 at 15:41  | Reason: Not specified

User
Posted 01 Sep 2020 at 07:50

I was told to expect some blood in semen. But the urologist didn’t say how much! Am 5 days post biopsy. Decided to try sex and was horrified by the amount of blood. It was like all of it was blood! Thinking the same as others, should try to expel as much as possible and ejaculated myself later in the afternoon. Again the whole thing was blood. 

My question is.. how much blood should i expect. When i used my open palm to hold all the liquid. It was all blood. Like a pool of blood in my cupped hand. I know advice is it is expected. But can anyone provide a guide as to how much blood to expect please. Thanks. 

User
Posted 01 Sep 2020 at 08:34

EdwardSprin,

Don't worry. Sounds perfectly normal after a biopsy. It seemed like I was just ejaculating blood to begin with. Gradually changes colour over time. Think It was a good 2 weeks for me before it cleared up.

User
Posted 01 Sep 2020 at 08:39

Thanks Mike. That is reassuring. I read the descriptions and no one is describing it like this. It is exactly how mine is. Ejaculating blood! Thank you! 

User
Posted 01 Sep 2020 at 09:39

If it looks like tomato ketchup, don't be surprised.

Yes, the leaflets they give you are way off. Mine said something like "there may be some blood in your semen for up to 6 weeks". Fortunately, I'd read forums beforehand, and knew what was possible.

I do one-to-one support of patients, and I've had 2 or 3 cases of men contacting me in sheer panic having ejaculated tomato ketchup just after a biopsy. The warnings beforehand (where they exist at all) are massively inadequate.

User
Posted 26 Sep 2020 at 00:35

Just read your answer after the same thing happened to me. Thank you, very reassuring. (I got the shock of my life!) 👍

User
Posted 26 Sep 2020 at 09:51

Just a quick follow up.. mine took about 2 weeks to clear up. 

User
Posted 15 Dec 2020 at 23:02

Still having brown ejaculate. Procedure was about three weeks ago. Also seems like there’s not as much as there was pre-biopsy. Very little comes out. 

User
Posted 15 Dec 2020 at 23:10

Hi Dj,

The fact it's brown means it's old blood, so I don't think that's anything to worry about. Any fresh bleeding would be red for a few days. It took me 3 weeks of ejaculating daily to get it all out, but the leaflet I was given said it could take up to 6 weeks.

Are you on hormone therapy? This will cause a reduction in semen, and for the GnRH drugs (Zoladex, Prostap/Lupron/Eligard, Decapeptyl, Firmagon/Degrelix), a complete cessation of semen.

User
Posted 19 Dec 2020 at 22:23

Hi,

It's 18 days since my transperineal biopsy. Ejaculate is very thin brown liquid with a consistency like water, not like ketchup as someone described, or simply some blood in semen, as I was told to expect. Has anyone had similar with it returning to normal colour and thickness? I'm seeing my Urologist tomorrow for results.

Thanks,

Carey.

User
Posted 19 Dec 2020 at 22:35

It's only bright red for about 3 days after bleeding. After that, the iron from the red blood cells changes oxidation state, and it is literally rust - your blood has gone rusty, hence the colour.

There are several components making up semen. The prostate's contribution is a clear fluid (mostly PSA). The seminal vesicles' contribution is the thick white gel. What can happen after someone has attacked the prostate with needles or radiotherapy is that you might lose one or other of the components. In your case, the ejaculatory ducts which carry the contribution from the seminal vesicles through the prostate may be blocked with clots or swelling, so you're missing their contribution. It will probably recover.

Edited by member 19 Dec 2020 at 22:38  | Reason: Not specified

User
Posted 20 Dec 2020 at 01:12

Thanks Andy62!

That's what I suspected. Apart from the result, I'm interested to find out how many cores were taken. I don't recall anything like this from the first biopsy.

User
Posted 23 Dec 2020 at 16:16

Hi Andy62 and others,

I saw my urologist and sections from all cores were negative for malignancy which is great news. There is some high grade PIN. PSA will continue to be monitored. What shocked me was that 41 needle cores were taken! No wonder recovery is taking some time.

It was a transperineal biopsy using Precision Point.

Has anyone here had a similar number of cores taken?

User
Posted 23 Dec 2020 at 18:12
30 - 50 cores is the normal range for a template / transperineal biopsy
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 23 Dec 2020 at 18:53

Was that under a general anesthetic?

I had 34 taken, but that was under general anesthetic and mainly targeted a specific area (anterior).

Before the current mpMRI scans, there used to be mapping biopsies, which is a type of transperineal template biopsy to sample all areas of the prostate. These were typically 100 cores.

With the development of effective transperineal local anesthetics over the past few years, they are doing transperineal biosies increasingly under local anesthetic.

The limit for TRUS was usually 12 samples, beyond which the patient becomes too uncomfortable.

 

User
Posted 25 Dec 2020 at 01:14

Thanks LynEyre and Andy62,

That's reassuring. This forum is so very helpful!

It was a general anaesthetic and I had an mpMRI about 2 years ago but that didn't indicate any specific area to target.

My best wishes to everyone here!

 

User
Posted 16 Jan 2021 at 00:06

I’m a little concern. Had my prostate biopsy done on 26 October last years. It’s been 11 weeks and I’m still having blood in my semen. Wondering if I should consult the doctor. 

User
Posted 16 Jan 2021 at 01:04

I think I would mention it to your doctor. It can take a while to clear up but 11 weeks is longer than I would expect. 

Dave

User
Posted 16 Jan 2021 at 08:20

Kian, that does seem like a long time. It was 3 weeks for me, and the leaflet I was given said up to 6 weeks. It does require a good number of ejaculations to get it out, and I did so daily to clear it in 3 weeks.

What colour is the blood? Blood is bright red for 3 days after it bled, but turns rust coloured after 3 days. So if the blood is bright red, you have fresh bleeding, but if it's been rust coloured except for first few days, then it hasn't bled since the procedure - it's just that you haven't got it all out.

Edited by member 16 Jan 2021 at 09:54  | Reason: Not specified

User
Posted 18 Jan 2021 at 15:41

Just to add to the proceedings. I am 2 weeks in and still ejaculating Lea and Perrins. I made the mistake of waiting a week before the first one and it was nigh on black!

User
Posted 18 Jan 2021 at 21:32

I've had a couple of support line calls from guys who waited a couple of months before daring to ejaculate, and were horrified to find it was black. It's the iron from the hemoglobin which has broken down and literally gone rusty. Not anything to worry about, but it may be better to get it out than leave it in there.

I didn't manage to get it all out from my second biopsy - I was already on hormone therapy and no longer ejaculating much. When I had a full body MRI scan a few months later, there's a bright white dot showing in my prostate. I asked the radiologist if that was the cancer because I didn't think it showed up that clearly. He said no, it's iron oxide left from blood which the body failed to reabsorb, and because iron oxide is magnetic there was enough there to show up bright white on an MRI scan.

Edited by member 18 Jan 2021 at 21:33  | Reason: Not specified

User
Posted 21 Jan 2021 at 13:15

Originally Posted by: Online Community Member

Hi Andy62 and others,

I saw my urologist and sections from all cores were negative for malignancy which is great news. There is some high grade PIN. PSA will continue to be monitored. What shocked me was that 41 needle cores were taken! No wonder recovery is taking some time.

It was a transperineal biopsy using Precision Point.

Has anyone here had a similar number of cores taken?

Can I ask what your PSA is Carey?

User
Posted 30 Jan 2021 at 04:53

Hi Dawnrazor,

It was 5.3 with 19% free/total ratio on 17/11/20.

Edited by member 30 Jan 2021 at 06:00  | Reason: Addressed to the person who asked the question.

User
Posted 30 Jan 2021 at 05:00

Originally Posted by: Online Community Member

Still having brown ejaculate. Procedure was about three weeks ago. Also seems like there’s not as much as there was pre-biopsy. Very little comes out. 

Hi dj,

Just wondering if everything returned to normal for you - colour, volume, consistency?

Carey

User
Posted 17 Aug 2021 at 14:24

Just joined the group as I have only recently had the (first?) biopsy, so no results yet. But I was worried about blood in semen as the doctor suggested it may happen. I was quite shocked the first time as it was all blood (or at least that's what it looked like). I see now that this has happened to others as well and believe it to be normal, but I am disconcerted that we have not been warned about it in any detail; the doctor suggested to me to produce semen after the procedure, but didn't warn me.

I managed three times since the procedure and it is still all dark red and abundant.

On a slightly unrelated topic, can an enlarged prostate limit the production of semen?

Thank you

User
Posted 17 Aug 2021 at 15:01
Yes, blood can appear in the seven for many weeks after biopsy - bright red at first and then a rusty brown over time.

An enlarged prostate doesn't directly reduce the amount of ejaculate that you see coming out but it can cause retrograde ejaculation which means it doesn't all come out and what is left is reabsorbed by the body.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 17 Aug 2021 at 15:03
Thank you LynEyre, I expected this to be the case, just wanted reassurance. It's all very interesting.

Kind regards

User
Posted 18 Aug 2021 at 12:18

I am wondering if one doesn't ejaculate after the procedure, what happens to all the blood that would have come out ? Is it re-absorbed in the body tissues? Does it go stale? And where exactly does it come from/is it stored, ion the prostate itself?

Edited by member 18 Aug 2021 at 12:19  | Reason: Not specified

User
Posted 19 Aug 2021 at 13:27

Some of the blood is broken down and the constituents reabsorbed by the body.

If there's too much, this doesn't work and a scab gets left there. This does make subsequent MRI scans more difficult to interpret.

In my case, I think I got it all out after the first biopsy. By the second biopsy, I was already on hormone therapy with very little ejaculate, and I didn't get it all out. A subsequent (second) MRI scan shows a bright white blob in my prostate. I was puzzled by this and asked the radiologist, saying I didn't think prostate cancer showed up so easily in MRI scans. It doesn't. He said this is the result of not getting all the blood out. What's left breaks down. The iron in the red blood cells becames concentrated, and because iron (or rust by this stage) is magnetic, it shows up very brightly on MRI scans. However, it would make further MRI scans of the prostate more difficult to interpret, if I ever need any. I now have a rusty prostate !

User
Posted 19 Aug 2021 at 14:50

@Aless

 

i had the same experience after the biospy. Mine was very bloody for about 5 weeks and cleared just before the RARP procedure. 

User
Posted 19 Aug 2021 at 17:44
So I presume that one should try to pass semen until the blood is cleared?
User
Posted 19 Aug 2021 at 18:55

Originally Posted by: Online Community Member
So I presume that one should try to pass semen until the blood is cleared?

 

From this site, other articles suggest abstaining from  3 to 7 days. We are all different and you should get advice from your own medical team. 

"Sexual problems

You can masturbate and have sex after a biopsy. If you have blood in your semen, you might want to use a condom until the bleeding stops."

I have quoted info from this site before only to find it wasn't 100 percent accurate.

On the basis that I was unlikely to have natural erections after surgery, I made the most of my natural erections. My volume of semen did reduce it the 4 months after diagnosis and biopsy.

Thanks Chris

User
Posted 21 Aug 2021 at 17:18

Aless

 

I felt the same after the biopsy and wanted to clear it of blood as soon as possible before surgery. It worried me the idea of leaving blood in my ball sac as I feared it may have contained cancer cells. In fact my surgeon told me it was completely normal and not to worry at all but I put the work in to clear it and it took 5 weeks or so! 

User
Posted 11 Sep 2021 at 13:02

A week since my biopsy and semen today is a bright red colour. How many weeks before it goes back to normal please?

User
Posted 11 Sep 2021 at 13:16

Depends how often you ejaculate.

Bright red suggests bleeding within last 3 days as the blood goes brown after about 3 days after bleeding, which in turn suggests you might still be bleeding.

There are some suggestions it's good to get it out. It took 3 weeks to go with daily ejaculation for me, but that was with no further bleeding after the biopsy.

User
Posted 11 Sep 2021 at 13:20

Mine got lighter as the weeks went by and had gone completely by 10 weeks. Though, unlike Andy62, I was not ejaculating daily

 

I am due to have a 30 core biopsy extraction on Thursday (16/09) so will experience the whole thing again

User
Posted 11 Sep 2021 at 13:31

Good luck with your next biopsy, I hope all will go well for you

User
Posted 15 Sep 2021 at 04:06
Thank heavens for this site! I was really panicking at the amount of blood.

Can anyone tell me how soon I can start exercising after a transperineal biopsy? The two different pamphlets I got at the hospital say different things. One says 2-3 days and the other says 7-10 days. Neither specify what constitutes "exercise". I always walk 5 km a day and do 20 minutes of yoga, then stretches and press-ups. I started the walking after two days but I'm hesitant at re-starting the yoga and strength exercises, in case it impedes healing. I'm itching to start the yoga especially, as it helps my anxiety, which is a bit off the meter after the whole biopsy situation.

User
Posted 15 Sep 2021 at 08:32

I wasn't told about excercising and started running 2 days after mine. Have I done the wrong thing?

 

User
Posted 15 Sep 2021 at 10:13

Most exercise is unlikely to be a problem. If you have a blood clotting disorder or you are taking blood thinners then more cautions is required. I think I would not do any cycling for quite a few days (perhaps a week, two if I were very cautious). Walking no big deal, Yoga: I wouldn't be doing the splits,  running maybe a few days, hurdling, high jump pole vault, maybe a bit longer. I can't imagine press-ups being a problem. 

 

Dave

User
Posted 16 Sep 2021 at 00:14
Thank you

User
Posted 19 Sep 2021 at 08:12
Another question: I'm about ten days past my transpineal biopsy and my urine was almost clear after three days. My ejaculate is still bloody, although since yesterday it's been a rusty colour and almost back to normal amount. Today my testicles are really tender and they may (I can't be absolutely sure of this) be a bit reddish in colour.

Has anyone had this happen, or should I be worried about an infection? (I wasn't given antibiotics).

User
Posted 19 Sep 2021 at 09:22

I have had 2 TP biopsies now (one on 04/06/21 and one on 16/09/21), with the first one being performed under a local anaesthetic and the second one under a general.

With regard to the first one, my urine was clear within 24 hours and my semen within about 10 weeks (though I did not ejaculate that often, hence the reason I think it took a while to clear). The paperwork I was given after my biopsy at Addenbrookes in Cambridge was that blood could be in the urine for up to a week and in the semen for up to 12 weeks. I did have a swelling around the area where the needles went in after about 4 days, and my testicles were a little tender too, but both cleared up a week or so after I first noticed the issue.

With regard to the second biopsy, I have detailed this on a post under my name but to save you searching this out will say this: I only had blood in my urine for a few hours after the procedure and 3 days after my semen is still blood red. I have, to date, had no pain or discomfort from the procedure.

Hopefully, others will come on and comment too, but if your testicles are still swollen after 10 days it might be worthwhile having a word with the doctor who undertook the biopsy to see what he thinks.

 

 

Edited by member 19 Sep 2021 at 09:29  | Reason: Not specified

 
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