The majority of patients with hemorrhagic sperm are not caused by any serious illness, but they should not be treated as a child’s play, because hemorrhagic sperm may also be caused by some serious diseases. The color change depends on the time of bleeding, if it is fresh bleeding, the semen color can be bright red, when the bleeding amount is more, the whole semen will be completely bloody, and will form a clot; if the interval between semen discharge is too long, the blood accumulates in the seminal vesicles for a long time, the iron in the blood is rusty after oxidation. If the bleeding is small and unilateral, the semen may only have a little blood in it; if the semen is repeatedly hemorrhagic for a long time, the blood clots deposited in the seminal vesicles will mechanize and slowly form stones. So where does the blood in semen come from? It is just a lesion in a part of the sperm pathway, such as bleeding, inflammation, or even a tumor. The majority of the components of semen, apart from the small volume of sperm, are liquid components called seminal plasma. 60%-80% of this liquid comes from the seminal vesicle gland and 20%-25% from the prostate gland. However, the prostate gland is a hard, solid tissue that does not bleed easily, while the seminal vesicle gland is cystic and has a very thin wall, so it bleeds easily once it becomes inflamed and congested. Therefore, the most common cause of hematospermia is vesiculitis, which can also be caused by inflammation of neighboring organs spreading to the seminal vesicles, causing inflammation, swelling, congestion and bleeding of the seminal vesicle wall. Most of the bleeding due to inflammation is sporadic but does not last long, while if it is accompanied by blood clots or stone formation, it will block the passage from the seminal vesicles to the urethra, thus making the inflammation recurring and not easy to eliminate completely, turning into stubborn hematospermia. Patients who also have a generalized tendency to bleed extensively are likely to have systemic bleeding disorders, such as hemophilia and thrombocytopenia. Sometimes, patients with hypertension may also develop hematospermia. Foreign studies have found that patients with prostate cancer are prone to hematospermia, so it is recommended that men over the age of 40 should be screened for prostate cancer if they develop hematospermia. Therefore, one should neither be overly nervous about hematosperm nor take it lightly, as it may also be a sign of some serious disease, and it is best to seek careful examination by a specialist. When people suddenly notice a change in the color of semen, they are nervous and often wonder what is going on. Clinically, hematosperm is only a symptom, not a disease term. When encountering a patient with hematospermia, a detailed consultation and systematic examination should be performed to find the cause of the hematospermia. Unfortunately, it is very difficult to diagnose the cause of hematospermia for two reasons: first, most patients with hematospermia do not have a clear cause, but only transient bleeding, which is clinically known as idiopathic hematospermia, and more than 70% of patients with hematospermia belong to this condition; second, the site of bleeding is relatively hidden, and although ultrasonography and MRI can detect the prostate and seminal vesicles to some extent, this is still not enough for a clear diagnosis. is still far from enough for a clear diagnosis. Therefore, how to accurately diagnose the cause of hematospermia has been a major problem for doctors. Because the cause is unclear, the effect of treatment can be imagined. In the past two years, the birth of a new technology has brought good news to patients with hematospermia, which is vesiculoscopy! The so-called vesiculoscopy is to insert a special long and thin endoscope into the urethra and find the opening of the ejaculatory ducts on both sides in the posterior urethra, through the tiny opening of the ejaculatory ducts the vesiculoscope can reach the seminal vesicles smoothly and the situation inside the seminal vesicles can be seen at a glance. This new technology can achieve two purposes, one is to understand the bleeding site and the cause of bleeding, and to stop the bleeding by electrocautery for the bleeding point, and to clip a small amount of tissue for further examination for suspicious lesions; the other purpose is to flush out the blood clots and stones in the seminal vesicles at the same time, and to unblock the passage of semen discharge to prevent the recurrence of hemostatic semen. We have observed through a large number of clinical cases that after seminoscopy, about more than half of the patients with hematospermia completely disappeared and no recurrence.