<s>[INST] When I ejaculate some dark red blood first appears then my semen which appears normal. I am a 66 year old male currently using Xarelto. My last PSA was around 1.0. The tip of my penis has a mild buring sensation after ejaculation. My urine is clear. I have a right side reducible inguinal hernia and will have surgery in the near future. [/INST] Hello dear, Thank you for your contact to Chat Doctor. I read and understand your concern. I am Chat Doctor answering your concern. There are two possible causes of the hemorrhage in you. First is the inguinal hernia which got obstructed, and the result is the hemorrhage. But this cause is associated with the severe pain. Which is absent on your complaint, so it can be excluded. Second cause is the anticoagulant Carlo. Anticoagulant helps to stop coagulate the blood. So I am afraid the coagulation procedure near vessels of the ejaculation duct is stop coagulating the blood the result is the bleeding. Other evidence in support is the absent of blood on the urine and present on the ejaculation. I advise you should change the Chat Doctor.  I advise you should visit nearby doctor because they will guide you  </s>