A patient, Li, male, 36 years old, was seen yesterday for more than 1 year for finding blood in semen. The patient complained of blood in his semen almost every time he ejaculated in the past 1 year, the amount of blood is sometimes more and sometimes less, irregular, dark in color, accompanied by painful ejaculation. The patient was highly nervous and did not feel like having sexual intercourse for a long time because of the fear of the appearance of bloody semen. The patient repeatedly asked, “Doctor, it is said that sperm and blood are of the same origin, one drop of blood is a drop of sperm, there is blood in my semen every time, will it kill me?” This is a typical case of seminal vesiculitis, which belongs to the category of “hematosperm” in Chinese medicine. So, can blood sperm really lead to the death of a person? It is one of the most common genitourinary infections in men, mostly in young and middle-aged men, with hematospermia as the main clinical manifestation, which belongs to the category of “hematospermia” in Chinese medicine. It is a common urogenital infection in men. Non-specific vesiculitis refers to a general infection of the seminal vesicles. The common germs include Escherichia coli, Aspergillus and Staphylococcus. Specific seminal vesiculitis is an infection caused by bacteria and fungi other than the general infection germs. For example: seminal vesicle tuberculosis, gonococcal vesiculitis, etc. 2.What causes seminal vesiculitis? (1) Upstream infection, which is caused by bacteria spreading upstream to the seminal vesicles through the urethra and ejaculatory ducts, is most common; (2) Lymphatic infection, which is caused by inflammation of the genitourinary tract or intestinal tract through the lymphatic route to infect the seminal vesicles; (3) Bloodstream infection, which is caused by pathogens from other parts of the body and an infection site through the bloodstream to infect the seminal vesicles. 3. What are the manifestations of vesiculitis? (1) Pain: Acute cases may have severe pain in the lower abdomen, radiating to the perineum and both groins. In chronic cases, there is a lot of vague pain in the suprapubic area, accompanied by discomfort in the perineum. Painful symptoms are significantly aggravated during ejaculation. (2) Urinary tract symptoms: In acute cases, symptoms of urinary urgency and painful urination are obvious, and difficulties in urination can be seen. In chronic cases, frequent and urgent urination with discomfort in urination and burning sensation is obvious. (3) Hemospermia: It is manifested as the discharge of hematosperm during ejaculation, and the semen is pink or red or with blood clots. In acute cases, the phenomenon of hematosperm is more obvious. (4) Other symptoms: Acute vesiculitis may have systemic symptoms such as fever, chills and chills. Hematuria, too, is one of the manifestations of acute vesiculitis. Chronic vesiculitis is mostly manifested as low libido, seminal emission and premature ejaculation. 4.What kind of examination is needed? (1) Semen routine examination: a large number of red blood cells and white blood cells are seen. Semen culture is positive. (Warm tip: semen specimen for abstinence 3-5 days is better!) Patients with acute seminal vesiculitis can see a significant increase in the number of white blood cells in the blood. (2) Ultrasound examination: also known as ultrasound, acute vesiculitis can be seen as enlarged seminal vesicles, which can be oval in shape, with hairy edges and disorganized dotted echogenicity within the vesicles after the formation of abscesses. If the patient has been ill for a long time, the seminal vesicles can be seen to shrink in size and shape, and the wall of the vesicle is thickened and rough, and the echogenicity of the vesicle is enhanced and the sound transmission is poor. (3) MRI: MRI is currently the most accurate method of non-invasive examination. It can accurately determine the size and shape of the seminal vesicles, the degree of bleeding, the presence of blood clots, and the presence of dilated ejaculatory ducts. (4) Vesiculoscopy: Vesiculoscopy is an invasive examination method that can observe the situation inside the seminal vesicles under direct vision and can be used for corresponding treatment under the vesiculoscope. It is the most direct and accurate method of examination and treatment for vesiculitis. The actual fact is that you can find a lot of people who are not able to get a good deal on a lot of things. The results of a survey show that about 80% of patients with vesiculitis infection are accompanied by prostatitis. (2) sexual dysfunction: vesiculitis can lead to painful intercourse, and the disease is not cured, recurrent episodes. The patient will also carry heavy psychological pressure for a long time, which will cause the occurrence of sexual dysfunction such as loss of libido and premature ejaculation. (3) Affects fertility: anatomy shows that the seminal vesicle gland and the prostate, vas deferens, urethra and bladder are in close proximity to each other and also in traffic with each other. Thus, it seems that seminal vesicle infection usually occurs after infection of other organs of the urogenital system. At the same time, the seminal vesicle fluid secreted by the seminal vesicle gland is an important component of seminal fluid. Therefore, seminal vesiculitis is likely to affect fertility. (4) It is possible to run out of semen: semen is made up of seminal fluid, prostate fluid and sperm, which are produced continuously by the seminal vesicle gland, prostate gland and testicles respectively, and there is absolutely no such thing as running out of semen. The amount of bleeding in the hemorrhagic sperm caused by vesiculitis is often very small, which is insignificant for the human body and does not usually lead to general anemia.