Lupron shot into bladder?

[NecessarilySo]

I had a Lupron shot two days ago and I noticed right after the shot I urinated a small amount of blood. This was the first time I had a Lupron shot in my "tummy". Previously it was in my buttocks. But for about 12-24 hours my urine was showing an orange color, different from usual, as if there was slight bleeding in my bladder.

I also had a numbing shot prior to the Lupron, which was a small needle.

Actually the injection was done twice. First time the nurse said she could not inject after inserting the needle. I asked if the needle was clogged and she said the Lupron was viscous, or thick. So she removed needle and redid the injection with a second Lupron and was successful.

The shots are only about 1/8" apart and they are still swollen a bit like the size of a pea.

My fear is that the injection which was on the left side of my abdomen, about 8 inches from my bellybutton, might have gone into my bladder and therefore would have been expelled as soon as I urinated. Since I was unable to urinate for three hours prior to the injection I felt it necessary to urinate just after, before driving home.

It actually seems that the injection site is quite a ways (3"?)from the bladder and the needle was only less than an inch. So it is kind of strange unless she hit the ureter.

Any comments will be appreciated.

[LearnAll]

Even if some lupron has entered your bladder..its not going to be a big issue because it will be eliminated within hours. As for small amount of blood, it will clot and the tiny wound will be healed in days.

[NecessarilySo in reply to LearnAll]

Yes it has healed, but my concern is that if it was injected into my ureter then it may not be effective since it will be expelled, not absorbed into the body.

[LearnAll in reply to NecessarilySo]

Thats right. It depends on how much it went into bladder and how much it went in muscles. No way to know.

[Gearhead]

I suspect that you were given Eligard and not Lupron (both, of course, are leuprolide acetate). Because: 1) Eligard is injected in the tummy fat and Lupron is injected in the hip. 2) As previous posts explain, there is a current Lupron shortage, so Eligard is being used instead (on me too).

Both involve mixing of two components just prior to (Eligard) or during (Lupron) injection. Perhaps your nurse was experienced with Lupron, but not Eligard. In my case, I receive leuprolide and Xgeva injections at the same 3-month intervals, and the process of injecting Eligard and Xgeva into belly fat look about the same to me. Do you have much belly fat? At the early stages of my ADT, before I had much belly fat, the nurse would "pinch" my minimal belly fat to form an adequate layer to ensure that the Xgeva was injected into fat.

My guess is that, if your nurse was inexperienced with this type of injection, it's conceivable that the Eligard was injected into your bladder. If that's the case, I agree with your concern that you've effectively missed some of all of your leuprolide shot. I suggest you contact your oncologist if you haven't already done so.

[NecessarilySo in reply to Gearhead]

Thank you Gearhead, seems you are right about Eligard but I see no information in paperwork about exactly what I received...it is called an EHHC injection but I don't know what that means. I messaged the MO and I suggested that we simply monitor the PSA and watch for a rise or fall to judge what happened, hit or miss, based on PSA.

It could be, since the first injection attempt failed, it penetrated the wall of the ureter and therefore was clogged rather than due to "viscous" mixture.. The second attempt succeeded, in slightly different location, so it might have missed the ureter. I will retake PSA every 4 weeks so that will help. (Urine flow looked like 2 drops of blood at end of flow, suggesting both attempts hit ureter, but of course that is a guess.) Seems the nurse was inexperienced, and I was also, as it was my first "tummy" injection. She did not seem to pinch belly fat and injected deeply, full needle length, ~3/4 inches.

I also will retake Lupron every 90 days (forever) so it is not a huge problem. Last Lupron shot 3 months ago lowered PSA from 35 to 0.3 over 90 days, so I expect a flat to small change over next 90 days, regardless. The Xtandi, 160 per day, will help to assure small change also. I expect 0.1 to 0.3 if Lupron went outside ureter, and less than 1 if it went uselessly into ureter. One or both shots hit a blood vessel inside ureter.

Thanks much for your input.

[mcp1941 in reply to Gearhead]

I have been getting 3 month Eligard injections for almost three years and all have been in the backside. Since starting Eligard, T has always been undetectable. When the nurse comes in the exam room I always ask to see the Eligard box before she opens it to verify that it is the 3 month dose and is Eligard. One time she had a box for the 6 month dose and I had her get the three month dose. She was very happy that I caught that before she opened the box. My MO wants me to only have the three month dose that is why I check it closely.

[NecessarilySo in reply to mcp1941]

Nice catch.

[Gearhead in reply to mcp1941]

youtube.com/watch?v=Knz04_u...(Not working as expected?)

This Eligard instructional video shows injection in tummy fat (even shows "pinch" that I mentioned). But audio says other subcutaneous locations (e.g., mcp1941's backside) are acceptable too.

[tango65]

Firmagon is given in the abdominal wall using an angle that will put the solution inside the abdominal wall. The first treatment wit Firmagon are 2 injections given in 2 different sites. The technique recommended to give the shots by the manufacturer will impide that the shot is given inside the bladder. Lupron is given intramuscularly in the buttocks. and usually it is only 1 shot.

If you have blood in the urine you need to consult with your MO and you primary physician.

[Gearhead in reply to tango65]

How does Firmagon come into the picture? NecessarilySo says "I had a Lupron shot...". So seems to me it could have been Lupron or Eligard (both Leuprolide), but was unlikely to have been Firmagon (Degarelix).

[tango65 in reply to Gearhead]

I always got my Lupron injections intramuscularly and the only ADT drug I got subcutaneously in the abdomen was Firmagon. My mistake.

[NecessarilySo in reply to tango65]

"intramuscularly" and "subcutaneously", are very cool words.

[RonnyBaby]

I had many tummy injections - some were more painful than others - NOT the same person did them.

Any connection to the bladder (hitting / missing the target) seems unlikely, but I admit there could be a chance of that happening IF the administration is done awkwardly.

The administrator needs to be forceful, to a point, to do it right.

Perhaps something else needs to be factored in ?

Better safe than sorry - I'd mention that event to my doctor(s) to get a satisfactory explanation.

[NecessarilySo in reply to RonnyBaby]

Right, diagrams show the bladder much lower. It would have had to be in the ureter. It was a good 20 minutes from the injection to urination. Also the blood was at the end of the flow. Later, urine color was orange, no clear blood drops, for about 12 hours. I messaged the doc. Thanks.