What are your next steps in workup for in a man over 40 with persistent hematospermia whose PSA, urinalysis, and urine culture are normal?

In this circumstance, I would probably obtain imaging with a pelvic MRI focusing on the prostate and SV's. Usually, what is seen is old blood products. But ruling out a cyst or other structural abnormality is the goal. If no significant irregularity is noted, a trial of finasteride 5 mg daily for 30...