### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hello. I am 52 and over 12 months ago my semen (amount and appearance) drastically diminished - I also had blood in the fluid that was ejaculated (sometimes bright red fresh blood or dark brown older blood).  Because there is so little fluid that is produced, there seems to be very little feeling upon orgasm, it feels like because almost nil is coming out, that the orgasm sensation has all but gone.  I have had my prostate checked as ok. I have never have taken any illegal drugs or steroids etc or had any injuries (that I know of).  Recently upon orgasm, the minute amount of fluid can also look like dark urine.  Over the past years I occasionally experienced a sharp type pain that I can best describe as being in the area approx. 6" up inside me from my groin.  That pain seems to have gone, but so has 95% of the fluid gone when I ejaculate and what is left is very watery and none of the usual viscosity. Could I have had a bad infection in the seminal vesicle and because it has been left untreated for so long that irreversible damage has been done? My GP is baffled, but has put me on a course of BACTRIM for 20 days (1 tablet in the morning and another in the evening), but my fear is if it was/is an infection that the damage is permanent (assuming this is the problem). Thank you Bill

### output:

Hi welcome to Chat Doctor. I have gone through your question. Your age is 52 and semen appearance is not good as bright red fresh blood seen with ejaculation, I would advise you to do first SEMEN ANALYSIS, then ultrasound of scrotum to see vascularity of testes, varicocele. Then consult a urologist with this report. He will advise you further. Hope I answered your question. Would be happy to help you further. Take care.