Reasons to refer a male with hematospermia to a specialist:
(1) presence of concomitant genitourinary pain
(2) presence of unexplained voiding symptoms
(3) recurrent and/or persistent and/or high volume hematospermia
(4) clinical findings suggesting a tumor
(5) clinical findings suggesting a structural problem
(6) elevated serum PSA levels
(7) abnormal urinalysis with sterile pyuria or unexplained hematuria
(8) suspect a foreign body
(9) suspect migration of a urinary stent
(10) suspect a vascular malformation
(11) failure to respond to appropriate management