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Last updated: September 25, 2025View editorial policy

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Differential Diagnosis for Hematospermia and Groin Pain

  • Single most likely diagnosis
    • Prostatitis: This condition, which involves inflammation of the prostate gland, can cause both hematospermia (blood in the semen) and groin pain due to the proximity of the prostate to the groin area and its involvement in the reproductive system.
  • Other Likely diagnoses
    • Epididymitis: Inflammation of the epididymis, a tube at the back of the testicle that stores and carries sperm, can cause pain in the groin area and potentially lead to hematospermia if the inflammation affects the seminal vesicles or prostate.
    • Seminal Vesiculitis: Inflammation of the seminal vesicles, which are involved in the production of semen, can cause hematospermia and pain that may be referred to the groin area.
    • Urethritis: Inflammation of the urethra can cause pain and potentially lead to hematospermia, especially if the inflammation is severe or caused by an infection that affects other parts of the urinary or reproductive system.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Testicular Torsion: Although more commonly associated with acute testicular pain, testicular torsion is a medical emergency that could potentially cause referred pain to the groin and, in rare cases, could be associated with hematospermia if there's significant testicular damage affecting the spermatic cord or surrounding structures.
    • Prostate Cancer: While less common in younger individuals, prostate cancer can cause hematospermia and groin pain due to metastasis or local invasion. Early detection is crucial for effective treatment.
  • Rare diagnoses
    • Vasculitis: Inflammation of the blood vessels can affect various parts of the body, including the reproductive system, potentially leading to both hematospermia and groin pain, though this would be a rare presentation.
    • Hemorrhage into a Testicular Cyst: A hemorrhagic cyst of the testis or epididymis could potentially cause both pain and, if the cyst communicates with the reproductive tract, hematospermia, though this is an uncommon scenario.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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