Hi,
New to this board. I am 54 and have had some months of blood in the semen...sometimes more sometimes less. Concerned I contact my Primary Care doctor and got a PSA check as well as some other blood work and urinalysis. This was my first PSA ever and the number was 20. The doc prescribed a course of Cipro which I told him I didn't want to take - so I did a course of Doxycycline instead. He also referred me to a Urologist.

About 3.5 weeks later I had the visit with the Urologist. My PSA at this visit was 38. Normal DRE. He wants to do an TRUS biopsy. I have had some minor aches/pains in groin, and rear area but these mostly in past month or so. I had back surgery 1.5 years ago and have lingering back pain I believe from that but hard to differentiate from whatever else may be going on. Other symptoms - getting up anywhere from 1 to 3 times a night to pee. I do drink a lot of wine leading up to bedtime. I otherwise seem to go okay - maybe smaller stream than I had when younger.

I am worried about infection risk from a biopsy. But also figure it is needed in case I do have cancer. I am worried about my numbers - research seems to indicate that high numbers like this might mean metastisized cancer. The antibiotic did nothing. The last time I ejaculated - about 1.5 week ago there was more blood than ever before and this time I felt a bit more of a pain - a pulling down towards the testicles or to right side of them then I have before

Is there a good chance I have prostatitis or some other issue besides cancer? Alternatives to biopsy?

Thanks for your input.

Make sure you get at least a weeks worth of antibiotics if they do the biopsy. Something that penetrates the prostate well to minimize any potential infection risks. Maybe start the medication 24-48 hours before the procedure if possible.

You may want to check out the following procedure just in case:

http://prostatitis.org/redirect.php?lin ... ultrasound

I am now 57. My first psa at age 45 was 4. No or maybe minor prostatitis symptoms Then psa went down to 2's

Then all the classic pain symptoms started around 48/49 yrs old - Perienum pain , testicle pain , burning in abdomen etc etc. and psa went popped up to 7's at Around 52 yrs old Had ct scan and biopsy as well as cystoscopies. No cancer found. My psa then stabilized down to the 4's and since dropped to low 2's. I think what caused my prostatitis was gut bacteria and transference to prostate and urinary tract and. Caused a low level undetectable infection and irritation to prostate . Modifying diet and taking xifaxin for gut bacteria helped me.

I would get biopsy if I were you. I think you most likely have prostatitis as your psa popped up from 20 to 30's. But given your age do the biopsy.

In my case I never had any blood or noted infection.

Do you have a lot of pain? When my psa went into the 4 to 7 range my pain was terrible. This

Hi,
Thank you for the response. I don't have a lot of pain...some pulling sensation on inside of right thigh at groin. Almost feels muscular. Back pain which may be related to back surgery. I've had a small amount of testicular tenderness on one side. I'll get the biopsy - I believe there is an antibiotic protocol to follow just before and after. Keeping my fingers crossed. Thanks for sharing your experience. I will follow up here after the biopsy later this month.

So to follow up:

I had the biopsy and I do have prostate cancer. It is considered to be fairly high risk so will be undergoing treatment shorty. Bone scan and MRI were negative so that's a plus. My psa went from 20 to 38 in about 3 or 4 weeks and then back to 24.3 about 3 weeks after that. So in my case hematospermia (blood in the semen) is likely a symptom of the cancer though I am told by my doc that I might also have some degree of prostatitis.

Thanks for the update.