Blood clots in bladder leading to urine blockage

[nad95]

Hello all,

My father had a radical prostatectomy in Aug, 2015 and then radiation in Feb, 2017 and is now on intermittent zoladex(adt) gleason-9 psa-0.10

Now he is having one serious problem I.e., blood in urine and then urinary blockage so we took him to the hospital and then catheterized him and did a ultrasound which showed a blood clot in bladder measuring 11.6cms. This is the 3rd time in 4 months and every time they catheterize him which he hates obviously. Any suggestions?

Thank you

[Ssiddy]

This is happening to my dad too. I took him to hospital last night. We are having scans today and appt with oncologist on Thursday so will let you know his thoughts.

[nad95 in reply to Ssiddy]

We went to the radiologist today and he told us that its radiation cystitis and there's no permanent solution to this.

Please let me know what your oncologist thinks

Thankyou

[j-o-h-n in reply to nad95]

F.Y.I.

Management of radiation cystitis.

Review article

Smit SG, et al. Nat Rev Urol. 2010.

Show full citation

Abstract

Acute radiation cystitis occurs during or soon after radiation treatment. It is usually self-limiting, and is generally managed conservatively. Late radiation cystitis, on the other hand, can develop from 6 months to 20 years after radiation therapy. The main presenting symptom is hematuria, which may vary from mild to severe, life-threatening hemorrhage. Initial management includes intravenous fluid replacement, blood transfusion if indicated and transurethral catheterization with bladder washout and irrigation. Oral or parenteral agents that can be used to control hematuria include conjugated estrogens, pentosan polysulfate or WF10. Cystoscopy with laser fulguration or electrocoagulation of bleeding points is sometimes effective. Injection of botulinum toxin A in the bladder wall may relieve irritative bladder symptoms. Intravesical instillation of aluminum, placental extract, prostaglandins or formalin can also be effective. More-aggressive treatment options include selective embolization or ligation of the internal iliac arteries. Surgical options include urinary diversion by percutaneous nephrostomy or intestinal conduit, with or without cystectomy. Hyperbaric oxygen therapy (HBOT) involves the administration of 100% oxygen at higher than atmospheric pressure. The reported success rate of HBOT for radiation cystitis varies from 60% to 92%. An important multicenter, double-blind, randomized, sham-controlled trial to evaluate the effectiveness of HBOT for refractory radiation cystitis is currently being conducted.

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 01/30/2019 6:40 PM EST

[Ssiddy in reply to nad95]

My dad is having further investigation on his bladder. They are not sure if tissue from the prostate is encroaching on the bladder or it is a blood clot. He is having a procedure next week to remove any tissue/tumour for a biopsy and clean out the bladder. Hopefully this will resolve the blockage problems.