Bleeding after salvage radiation

About a month after I finished 38 rounds of salvage radiation l started to have some blood and blood clots in my urine. The amount is low, but is is enough to stain my pads (still have stress inconstance) and make the bowl red. In addition there is often a slight pain when I urinate - like I am trying to pass a blood clot. The radio oncologist stated that this often happens and is from scabs coming off from the radiation. He stated that it should clear up after a while and to drink plenty of water.

Has this happened to others? If so, did it clear up on its own?

58 when diagnosed

4/18/2016 DaVinci surgery

Gleason 8 (4+4) T3aN1Mx ductal Stage 4 D1 prostate 74 g, 1/14 lymth nodes "100%" cancer.

PSA= 3.3 2014, 4.7 2015, after surgery 0.1 5/2016, < 0.1 9/30/2016

6/2/2016. Needle biopsy of swollen pelvic lymph node negative

Hormonal 6/2/2016 Lupron two year treatment

External radiation: 38 treatments ended 10/7/2016

Leakage 6/28/2016 > 250 g/day, 7/6/2016 < 10

10 Replies

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  • Doctor, If the bleeding continues read my advanced prostate cancer blog post at:

    advancedprostatecancer.net/...

    Joel

  • Happened to me about 18 mths after adjuvant MRT. Initially blood then clots then full blockages. Boy was it painful. Drinking a lot helps but it's a double edged sword because it flushes the waterworks but if it doesn't and a big clots blocks the urethra (like happened to me on holiday in the middle of rural France with no English speakers around) it can get problematic and very painful. I had repeated cystoscopies and occurrences despite those. What finally appears to have fixed it was 9 weeks of 2 hours daily in a hyperbaric decompression chamber on 100% oxygen to encourage the growth of new blood vessels in the bladder wall.

  • Apparently this is something doctors don't discuss with their patients. After IMRT back in 2010, I was almost fully blocked about three years ago. Not only did I suffer the pain of it, my urologist didn't treat it. After the fact, I found that it was noted in my medical records at the time. Mighty F'd up. I wound up in the ER twice, and finally, FINALLY, am having the catheter removed on Wednesday. I had a Urolift done as opposed to having TURP.

    During the repair time, I passed thousands, if not millions of clots. Some very small, and some about the size of a red worm. Just Friday, I passed a scab type clot and some very red blood, and just as quick as it came, it was gone. I'm also passing some whitish material, also. But, all in all, I know I am healing. It's been a long road with this issue that didn't have to happen.

    Joe

  • I'm with you brother. Besides blood clots, although no wherer near as many as you, I also passed a small piece of gauze my urologist somehow left behind!! But It will improve. Do the hyperbaric as inconvenient as it is. Hang in there.

    Cheers

    Janis

  • I had bloody urine several times post RP. My surgeon said that was normal and it cleared up fairly quickly.

  • Hi Dr,

    Have your Urologist check your bladder by ultrasound to see if your fully voiding. And, have them do it twice. On a Friday afternoon my test showed I had 123 cc in my bladder. When I wound up in the ER, a CT Scan showed my bladder over-extended. Saturday morning, after being cathetered, I passed 2 1/2 quarts of blood and urine. This was all due too Cystitis from the IMRT I had in early 2010. Also, be alert for the same problem from the back end. I now have a new Urologist.

    Joe

  • Dr,

    I have to add that I also had a mostly closed urethra, which was easily clogged. I had a Urolift procedure to open her up. The catheter comes out on Wednesday. It's about time.

    Joe

  • Thank you one and all for you comments and suggestions. That is what makes it a great group. Luckily for me this morning there was no pain and blood in my urine.

    Considering oxygen treatment, hopefully (if I continue to recover) I will be going SCUBA diving where I will be under a little over three atmospheres of pressure. I wonder if this will have the same effect as being in a pressure chamber?

  • No Scuba isn't the same. You need to have 100% oxygen under pressure over a long period of time to encourage growth of new blood vessels.

  • Wow. This discussion might validate my decision to go the HIFU route rather than the IMRT radiation (45 treatments) recommended. I did have painful urination and blood in my urine for several weeks post surgery. One thing I did was to stop taking all NSAIDS. I didn't see a gross hematuria episode after that. Good luck Doc.

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