Thanks for clarifying the situation...I hope things improve fast for you.
From what I read (and please understand, I'm not a medical
professional...see the disclaimer at the bottom of this page), I've
gleaned the following:
--lumpy and/or discolored semen is not uncommon, and is not
necessarily a sign of anything serious.
--it is sometimes, not always, mildly painful
--the cause can't always be pinpointed
--however, a bacterial infection often can be the cause, and generally
responds well to treatment with antibiotics
--there certainly are diagnostic tests that a doctor could use, but
the sense I had is that many doctors take the same route that yours
did -- making an assessment with a rectal exam, assuming that
antibiotics are worth a shot, and not bothering with further tests to
confirm an infection.
Here's the information I found on possible causes of lumpy and painful ejaculation:
What is prostatitis and how is it treated?
Prostatitis (pronounced "PRAH-stuh-TYE-tis") is an inflammation or
infection of the prostate gland. It affects at least half of all men
at some time in their lives. Having this condition does not increase
your risk of any other prostate disease.
Trouble passing urine or pain when passing urine
A burning or stinging feeling when passing urine
Strong, frequent urge to pass urine, even when there is only a small
amount of urine
Chills and high fever
Low back pain or body aches
Pain low in the belly, groin, or behind the scrotum
Rectal pressure or pain
Urethral discharge with bowel movements
Genital and rectal throbbing
Sexual problems and loss of sex drive
Painful ejaculation (sexual climax)
Prostatitis is not contagious. It is not spread through sexual
contact. Your partner cannot catch this infection from you.
Several tests, such as DRE [NOTE from paf -- DRE=digital rectal
examination] and a urine test, can be done to see if you have
prostatitis. Getting the right diagnosis of your exact type of
prostatitis is the key to getting the best treatment. Even if you have
no symptoms, you should follow your doctor's suggestion to complete
There are four types of prostatitis:
Acute bacterial prostatitis
This infection comes on suddenly (acute) and is caused by bacteria.
Symptoms include severe chills and fever. There is often blood in the
urine. You must go to the doctor's office or emergency room for
treatment. It's the least common of the four types, yet it's the
easiest to diagnose and treat.
Treatment: Most cases can be cured with a high dose of
antibiotics, taken for 7 to 14 days, and then lower doses for several
weeks. You may also need drugs to help with pain or discomfort.
Chronic bacterial prostatitis
Also caused by bacteria, this condition doesn't come on suddenly, but
it can be bothersome. The only symptom you may have is bladder
infections that keep coming back. The cause may be a defect in the
prostate that lets bacteria collect in the urinary tract.
Treatment: Antibiotic treatment over a longer period of time is
best for this type. Treatment lasts from 4 to 12 weeks. This type of
treatment clears up about 60 percent of cases. Long-term, low-dose
antibiotics may help relieve symptoms in cases that won't clear up.
Chronic prostatitis or chronic pelvic pain syndrome
This disorder is the most common but least understood form of the
disease. Found in men of any age from late teens to elderly, its
symptoms go away and then return without warning. There can be pain or
discomfort in the groin or bladder area.
Treatment: There are several different treatments for this
problem, based on your symptoms. These include antibiotics and other
medicines, such as alpha-blockers. Alpha-blockers relax muscle tissue
in the prostate to make passing urine easier.
Asymptomatic inflammatory prostatitis
You usually don't have symptoms with this condition. It is often found
when your doctor is looking for other conditions like infertility or
prostate cancer. If you have this problem, often your PSA test (see
The PSA Test) will show a higher number than normal. It does not
necessarily mean that you have cancer.
Treatment: Men with this condition are usually given antibiotics
for 4 to 6 weeks, and then have another PSA test.
[symptoms can also be associated with prostate cancer, but this is much more rare]
If prostate cancer develops and is not treated, it can cause these symptoms:
painful or burning urination
difficulty in having an erection
blood in urine or semen
pain or stiffness in the lower back, hips, or upper thighs.
Blood in the semen
Blood in the semen, called hematospermia, may be undetectable
(microscopic) or visible in the ejaculation fluid.
Associated symptoms may include:
Pain with urination
Pain with ejaculation
Pain with bowel movement
Tenderness in the scrotum
Swelling in scrotum
Swelling or tenderness in groin area
Lower back pain
Fever or chills
Blood in urine
Blood in the semen may be caused by inflammation, infection, blockage,
or injury anywhere along the male reproductive tract. It may indicate
disease or a problem within the urethra, testicles, epididymis, or
Blood in the semen is usually the result of inflammation of the
seminal vesicles, and will usually go away spontaneously. Often, the
cause can not be determined. If the blood does not clear and ejaculate
is persistently stained with blood, more extensive tests should be
done, such as urinalysis and culture, semen analysis and culture, and
ultrasound of the seminal vesicles.
Minor injuries may be treated with rest, applying ice, and monitoring
symptoms. Major injuries may require reconstructive surgery.
Infections can often be treated with antibiotics taken by mouth (or
intravenous antibiotics if symptoms are severe).
Blockages are typically treated with surgery. If cancerous tumors are
the source of obstruction, radiation and/or chemotherapy may also be
What to expect at your health care provider's office
The doctor will perform a physical examination, looking especially for
fever swollen lymph nodes, a swollen or tender scrotum, discharge from
your urethra, or an enlarged or tender prostate.
To help diagnose the cause of the problem, your doctor will ask
medical history questions, such as:
How much blood was in the semen?
Was microscopic blood ever noticed in the past when the semen was
examined for another reason?
When was this first noticed? Is it present all the time?
Is there anything that seems to have caused this symptom?
What other symptoms do you have?
The following diagnostic tests may be performed:
Triple-void urine specimens are collected for urinalysis and urine culture:
after examiner massages the prostate
Ultrasound of pelvis and scrotum
The urinalysis may show high white blood cells.
A culture of of the urine after prostatic massage may show bacterial
growth and high levels of white blood cells. However, your health care
provider may choose not to massage your prostate if it is obviously
swollen and tender, because massage may potentially spread the
infection. This could lead to bacteremia or sepsis (generalized
infection in which bacteria are present in your bloodstream, not just
This extremely common condition is an infection or inflammation of the
prostate. It is caused by the spread of infection in the bladder or
urethra. Prostatitis affects as many as 60% of all males and can
occur in men of all ages from puberty on.
Pain or burning sensation during urination
A frequent sensation of having a full bladder
Burning with ejaculation
Blood in the Semen
Alternate Names : Hematospermia, Hemospermia
Blood in the semen is uncommon. Seeing it can make people quite
anxious, but it is rarely serious.
What is going on in the body?
Most cases of blood in the semen are from unknown causes. It usually
goes away on its own.
What are the causes and risks of the condition?
Most cases are from an unknown cause. Known causes include:
infections of the prostate gland, called prostatitis. Prostatitis may
be acute, chronic, or nonbacterial.
infections of the seminal vesicles, which are two structures that
secrete some of the fluid found in semen
infections of the urethra, known as urethritis. The urethra is the
tube that carries urine and semen to the outside of the body.
urethral strictures, or narrowing in an area of the urethra. This may
be caused by trauma or a previous infection.
certain sexual habits, such as prolonged abstinence from or lack of
sex or unusually frequent sex
bleeding or blood clotting problems, such as hemophilia A or
hemophilia B. Clotting problems can also occur in men who are taking
too much of the blood-thinning drug warfarin.
tumors or cancer, a rare cause. The cancer may be in the prostate,
seminal vesicles, or urethra.
NOTE that there are other links here near the top of the page to
additional information, including:
Overview, Causes, & Risk Factors | Symptoms & Signs | Diagnosis &
Tests | Prevention & Expectations | Treatment & Monitoring | Pictures
and Images | Attribution
[a number of links below have forum-like or Q&A discussions of a
variety of semen-related issues, especially odd lumps and odd colors
in the semen. Please go directly to the links themselves to read the
Genital Problems in Men
Sexual Problems - Ejaculation and Semen
[There are a number of Q&A's here pertaining to painful and lumpy or
Is my semen normal?
and the one that get my vote for least informative answer in an
internet health forum is:
Q: I can see gelatin like lumps in my semen. it usually comes out
last. what is it? is this serious?
A: It may happen. It is not serious. You change from time to time,
and so does your semen.
That's most of what I came up with.
There were a number of technical papers as well that mentioned blood
in the semen as a side effect of some prescription medications or
post-operative conditions, but I did not include these here as they
don't seem relevant to your circumstances.
Also, I did NOT see any relation between these symptoms and the
immunological infertility that you mentioned. This type of
infertility can be associated with the presence of white blood cells
in semen, but I didn't see anything that linked to your your
particular cluser of symptoms.
I trust the information I've provided here fully answers your question.
However, please don't rate this answer until you have everything you
need. If you would like any additional information, just post a
Request for Clarification to let me know how I can assist you further,
and I'm at your service.
All the best,
search strategy --Google searches on:
"painful ejaculation" OR "blood in * semen" OR "bloody semen" OR
"lumps in semen" OR "lumps in * semen"
blood semen "immunological infertility"