Blood in semen after biopsy

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

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.

Just want to say a huge "thanks" to everyone who has posted on the forum about this delicate subject 😂

It is true that NONE of the pre-biopsy stuff tells you what is likely to happen the first time you come after the procedure - and I thought I'd read everything (I only found this forum via a hurried Goggle search after the first horror show ejaculation. )

It's a huge relief that "you may have some blood in your semen after the biopsy" actually means "Your ejaculate will most likely look like Heinz Ketchup for 3 weeks then HP Sauce for another 3 weeks"

I think I will mention it to the Urology team - as they are going to be updating their advice sheet pretty soon, they tell me.

For those of a scientific bent - this is an excellent paper on the subject in a very reputable journal.

https://www.nature.com/articles/4500955

(The technical term is for blood in semen used throughout the paper is - hemospermia - but it's pretty comprehensible for a non-technical audience)

Again - many, many thanks for the candid reports and discussion here. 👍

Edited by member 12 Mar 2022 at 11:34  | Reason: Spelling

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.

Yes I've found that there's a lot of stuff that happens to us blokes with all these procedures and treatments that isn't in the brochure!

HT giving you mental and emotional breakdowns.

If you don't do penile rehabilitation, your cock won't return to it's magnificence after coming off HT!

This forum can help prepare and aid men going thru all this.

Have a look at my blog...I've gone thru PSA test over a year ago...thru MRI, trus biopsy, bone scan, CT scan, PSMA PET scan, mixed HT, sorry, Chemical Castration, and just finished RT. Plus a litany of NHS failures and cock ups!

Always happy to chat with other sufferers...via my blog.

Cheers

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

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

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

I just wanted to post my gratitude at having found this forum. Had a transperineal biopsy on 16th Dec. Listened to the nurse and read the leaflet about there sometimes being a bit of blood in the urine or semen - got the impression that there might be the odd trace or fleck or spot (I'm laughing at my naivete now! :-) . I saw a tiny bit in the urine on 16th and thought that was that. I am not particularly sexually active at the moment (though not dead in the water!) and thought I just wouldn't masturbate anyway for a few weeks. However I think my curiosity as to the idea of blood in my semen got the better of me and I thought I would see what it was like. Also I have an ongoing 'fairly casual' sexual relationship with someone and am likely to meet them in January so I thought it might be best to see what was in store for both of us. Well......I have to say (and apologies for the bluntness here)  that I was traumatised by what came out of my penis! First of all - there was a lot of it - more than I would normally ejaculate! Secondly there was the colour of it - this was not semen slightly tinged or a bit rust coloured as I had been led to believe. This was rivers of red blood. This was horror movie stuff! 

I spent the rest of the day quietly worried about this and re-read the leaflets to see if I had missed something. I hadn't. There was no warning of anything other than the phrase 'Your semen may be discoloured (pink or brown). I felt very worried about masturbating again and was beginning to really regret letting those medical people at me with their knives and needles. But eventually I did a bit of research. I never thought the day would come when I would enter the phrase 'I have just ejaculated a lot of blood..is this normal...biopsy...' into Google but was so relieved to find this thread and this forum generally. 

and now in far more information than anyone needs can say that I have 'done it again' with similar results but at least feeling very reassured that it will pass and that I am not alone.

I am also going to tell my urologist and the specialist nurse that they really do need to be warning people that when they say that there could be blood in the semen that they mean that you will actually give the appearance of ejaculating lots of blood and that this is ok.

Thanks for posting your stuff. I imagine that I may use this forum a lot in the coming weeks and months. I won't have my biopsy results until mid to late January apparently and so I am just carrying on 'as normal' until then. 

Been through the procedures after a PSA test of 5.7. Urine test, MRI scan, then 12 days ago a Trans-Perineal Biopsy. Get my results in a week.

I'd googled for info on the expected colour of semen at this stage after the procedure and thankfully found this thread.

For reference I started masturbating after approximately 3 days once discomfort in that area had abated. My first came out like tomato sauce (ketchup) as other people had noted. It is currently still a very dark reddy brown that I don't think I've seen on any Dulux colour chart, though I expect Farrow and Ball probably do it :)

Thanks all for the useful information.
I too was floored by how bad the semen looked after the biopsy.
Yeah I'd read the warnings that there will be "some" blood in semen for quite a few weeks afterwards. But it doesn't in anyway quite prepare you for the reality.
Blood in my urine took about a week to sort itself, but was quite clear after a few days.
My wife decided to check my semen 3 days after the biopsy. Whilst I didn't object :).....the result was a pretty damn quick way of eradicating the erection I can tell you!
I saw the look of horror on her face, and bless her, she quickly tried to hide the semen and spare my concern.
Had I even seen a spot of blood in my urine or semen before this I would have gone wobbly at the knees, but thankfully this time I was a little prepared.
3 days might have been too soon though to avoid the throbbing of my undercarriage and rear end afterward, but hey ho.

Edited by member 30 Jul 2023 at 23:55  | Reason: Spelling Mistake

I let my wife know that I was told this needed to be done to ensure that it was cleared out over the course of the first week or so... 😉

It really is annoying that the doctor and the hospital where we have these biopsies performed don't warn us.  Scared the living daylights out of me. It was like a murder scene.  My biopsy was way back in ~Feb. 2025, and I'd say it took about 15 or so times to clear it. I do recommend doing so to the best of your ability. I'm now on active surveillance for a 0.5 mm spot in there (3+3 = 6 Gleason), so if the next PSA has escalated, I'd expect another MRI, blah blah. 

At least if I have to have another biopsy, I'll be mentally prepared for the after effects.

But, you really have to keep going if you have to have another biopsy. A true case of sucking it up and all that for your own health rather than avoiding it.