An anxious colleague recently came into my office and closed the door. After a moment of stunned silence, I asked him about his prostate-specific antigen PSA level and whether he had had a biopsy. Few things alarm a man and his partner more than seeing bloody ejaculate, a condition called hematospermia, or hemospermia. It conjures fears of cancer or a sexually transmitted disease. In many instances, it has no apparent cause.
Sometimes it takes the licensing and advertising of a treatment to get patients to seek help, even for a medical problem that is often painful and psychologically devastating. It most often afflicts middle-aged men, usually the result of an injury that may not have been noticed. Injury can occur during a sports activity, accident or vigorous sex when the erect penis is bent or pounded against bone. In repairing the damage, the body creates plaques of scar tissue under the skin of the penis, causing it to bend or curve abnormally or become indented when erect. Xiaflex contains an enzyme, collagenase, that in four cycles of treatment is injected directly into the plaque to destroy it and reduce the curvature.
During erection, prior to reaching orgasm, the bladder neck closes, and the bulbourethral glands which sit under the prostate gland and open into the urethra emit a small amount of fluid called pre-ejaculate. This fluid serves to lubricate the urethra as well as to neutralize the acidity of any remaining urine within the urethra, since the acidity can be damaging to sperm. During orgasm, the stimulation of the sympathetic nervous system causes muscular contractions of the vas deferens, thereby carrying the accumulated vasal sperm into the ejaculatory ducts.
Prostatitis is swelling and inflammation of the prostate gland, a walnut-sized gland situated directly below the bladder in men. The prostate gland produces fluid semen that nourishes and transports sperm. Prostatitis often causes painful or difficult urination.