Q: I am a 41 years old man suffering from high blood pressure and ulcerative colitis. Recently I had an episode of haemospermia, so I got transrectal ultrasonography (TRUS) done, in which prostatitis and early benign prostatic hyperplasia (BPH) was diagnosed. My fasting blood sugar level is 100 mg/dl, activated partial thromboplastin time (APTT) is 34 seconds, serum creatinine - 0.85 mg and HbA1C - 5.9%. Urine and semen culture showed no growth. However, few pus cells in semen/urine were found. No bacteria in urine. No macrophages or malignancy in semen/urine. The doctor prescribed Loxof 500 and Alfoo 10 mg daily for 21 days. He also suggested steam bath and prostatic massage twice daily. Is this massage safe? Is cystoscopy necessary? Please advise.

A:Haemospermia is mostly a benign condition. You have many associated diseases but have not listed the medications you are taking. Many people on blood thinners like aspirin (ecospirin) may suffer bleeding without any pathology. The most common cause of haemospermia, though, is prostatitis, as probably in your case. It is usually treated medically with prolonged low dose of antibiotic course, extending to 8 to 12 weeks. No, it is usually not advisable to have prostatic massage as it may add mechanical trauma to already inflamed gland. Cystoscopy too may not be necessary unless it is associated with presence of blood (RBCs) in urine.