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The doctor will perform a physical examination. The doctor will look for fever, swollen lymph nodes, a swollen or tender scrotum, discharge from the urethra, or an enlarged or tender prostate.
To help diagnose the cause of the problem, your doctor will ask medical history questions, such as:
- How much blood was in the semen?
- Was microscopic blood ever noticed in the past when the semen was examined for another reason?
- When was this first noticed? Is it present all the time?
- Is there anything that seems to have caused this symptom?
- What other symptoms do you have?
The following diagnostic tests may be performed:
- Triple-void urine specimens are collected for urinalysis and urine culture:
- Initial stream
- Midstream
- After examiner massages the prostate
- Semen analysis
- Semen culture
- Ultrasound of pelvis and scrotum
The urinalysis may show high white blood cells.
A culture of the urine after prostatic massage may show bacterial growth and high levels of white blood cells. However, your health care provider may choose not to massage your prostate if it is obviously swollen and tender, because massage may potentially spread the infection. This could lead to bacteremia or sepsis (generalized infection in which bacteria are present in your bloodstream, not just the prostate).
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