Haematospermia

[AeliusGalenus]

I'm 70 and have had bouts of heamospermia on and off for several years now. In fact the amount of fluid ejaculated, with/without blood present has been getting less and less over the time span. Pre-cum is clear.
Following a cardiology examination 2 or so years ago I was put on the blood thinner rivaroxaban after paroxysmal atrial fibrillation was diagnosed. Very soon after I developed very noticeable hematuria. Full set of urological tests, CT scans etc were carried out and nothing was found . The hematuria stopped soon after on its own accord and has not recurred thankfully. However occasional bouts of haemaspermia continue although not at present. What could be the cause?

[Mr Benjamin Challacombe]

Haematospermia is always very worrying but thankfully unlikely to be due to a nasty cause.
Most likely are small stones in the prostate or a vein on the inner prostate surface that bleeds. Reassuringly you have already had a CT and flexible cystoscopy to rule out bladder cancer or major other issues. The Rivaroxaban won't be causing it but might be contributing.
Would be worth having a DRE prostate exam and PSA test
If prolonged i usually get an MRI scan to look more closely at the prostate and do an ejaculation test for infection in case an unusual infection is the cause.