Blood in the urine

[old64horn]

Two months ago I noticed blood in my Urine. It only happened once but then in September, it happened again so my Urologist performed a cystoscopy in his office and saw some irritation in the bladder that may have been a result of the IMRT I had last year. . He ordered a CT scan of my groin area that ruled out the presence of stones in the kidney or bladder. It did show two cysts (one in each kidney) that he considered to be common in older men. the blood seems to come and go depending on my level of physical activity. Did any one have similar situation? Where is the blood coming from? By the way, I have never been on ADT or any other drug. Thanks

[Don_1213]

Hmmm... I'm just a kid (4 years younger than you..) but I had similar hematuria (bloody-piss) after getting green-laser treatment for urinary constrictions and radiation treatments (IG/IMRT, 83 Gy for G-10).

My medical oncologist strongly urged a cystoscopy (to rule out bladder cancer) which I had at Weill-Cornell/Columbia in NYC. The cystoscopy was actually almost pleasant, there was no pain involved at all, and the urologist doing it shared what he was seeing on the monitors and explained what he saw. I had scar tissue in the urethra near the bladder neck. This was possibly due to the radiation treatments and perhaps made worse by the subsequent green-laser treatment. It might also have been partly caused by blood-thinners I'm on for cardio disorders (stents and that sort of thing.)

I only had bleeding after.. Ummm... manually exercising that area, and they were short-lived (not more than a day..) This eventually cleared all by itself with no treatment necessary.

So to directly answer your question - mine came from scar tissue which might have been caused by radiation treatments or might have been caused by green laser treatment (to clear a urinary obstruction.) In any case - it cleared up on its own. Hopefully, yours does the same.

If yours doesn't - you might look into hyperbaric treatments (pressurized oxygen treatments) which seem to aid healing of this sort of thing. I was considering those if mine didn't clear up by itself.

[Tall_Allen]

It's normal and expected for some scar tissue to slough off in the urine stream, even years after radiation. If you leave it alone, it will go away. Unfortunately, you had a cystoscopy, which scraped off more tissue and further exacerbated the situation. It's like picking at a scab - the more you do it, the worse the healing.

[old64horn in reply to Tall_Allen]

thanks Allen, I appreciate your response. I wonder why it seems to happen when I exercise more

[Tall_Allen]

Movement disrupts the scar tissue.

[spencoid2 in reply to Tall_Allen]

mine comes and goes with no rhyme or reason. some times it is blood, some times clotted blood or tissue. some times it passes easily and some times it blocks urination.

my urologist suggested that even minor bleeding from broken capillaries can clump into a clot and look like a real mess but not be especially bad as long as it does not block urination.

every time i pee it is a surprise if it is painful bloody or not. this is 9 years after radiation and maybe 5 after a TURP.

[leebeth]

My husband had a severe case of radiation cystitis which began about 6-7 months after radiation. He had hematuria, urgency, frequency, discomfort. He had 40 sessions in hyperbaric oxygen chamber and it completely resolved.

[Rlsheffie in reply to leebeth]

40 sessions? I looked up hyperbaric therapy and it sounded like 1 or 2. I have had similar bleeding several years after radiation (39 sessions) and two trips to emergency for blood clots causing blockage. Dr has mentioned hyperbaric as a possibility

[Aljr2004 in reply to Rlsheffie]

Rushefie - You should insist on HBOT starting sooner rather than later. My experience with Late Radiation Cystitis is that it started 5 years after radiation, then progressively worsened. First round of HBOT did not help - likely because 9 years of build up so I am trying again.

[leebeth in reply to Aljr2004]

I agree! I found research that suggested the outcomes were improved if hyperbaric treatments were initiated within 6 months of symptoms starting. His urologist was not going to recommend it so early, but I pushed for it. When I say “early”, he had had hematuria and severe symptoms for 3 months by the time he actually started the treatments, and his hemoglobin had dropped to 7.7.

His improvement began after just a few sessions. He was so miserable prior to that. We couldn’t really go anywhere. He was constantly in the bathroom.

[leebeth in reply to Rlsheffie]

Yes, a 40 session course is the standard. He just finished a week ago, and the hyperbaric doctor wants him to see his urologist to make sure he doesn’t need more. Since his symptoms are completely alleviated, I don’t see the point.

[Rlsheffie in reply to leebeth]

I might have to travel 2 hours to Philadelphia for hypobaric treatment. May I ask where you went?

[leebeth in reply to Rlsheffie]

We live in SE Wisconsin, and our small town has hyperbaric chambers at 2 of the hospital systems. My husband went to Advocate Aurora, and it is only 10 minutes from our house.

That would be very prohibitive to travel 2 hours. His appointments weee at 8 every morning, and he was home by 10:15-10:30. He retired right before starting, but his employer would have been fine with him starting at 11 each day.

One thing we appreciated was that it was ok to miss a day if we had a scheduling conflict. So, he started his 40 sessions on July 12, and finished on September 21. They were very flexible, as some of his other medical appointments took priority, like traveling to MN to get his first dose of Pluvicto.

[mrssnappy in reply to Rlsheffie]

You may want to look into renting one.

[Aljr2004 in reply to Rlsheffie]

I use St Mary Wound Care in Langhorne- roughly 20 miles south of Philadelphia. Langhorne has a second business that also has the chambers.

[Munchkin2840 in reply to Rlsheffie]

I had the same condition/situation that leebeth mentioned.

The Hyperberic Treatment also resolved my bleeding/clotting condition.

Highly recommend for anyone with this condition.

[Billikan]

I'll be 80 in a few weeks. I've had blood in my urine from sitting on a hard surface like the edge of a raised garden bed or a hard stool. I had to stop riding a bicycle because I'd find blood in my urine as well as pain in the prostate area. My prostate is intact but very large ~100cc.

[Steve507]

Gross Hematuria (IMRT in Feb 2020)

A week ago, I went for my first pee of the day--it was bright red followed by normal looking urine. I hopped on my cruiser and went to the local medical testing lab for urine and blood work, as well as makimg an appt with a urologists for later that day. While waiting two hours for the lab results, I drank about 1 liter of water and had one hand crafted Czech lager at my fav pub. There I peed twice more but now I noticed my urine flow was blocked momentarily. Again, first blood then urine followed.

I returned to the lab for results (before seeing the Urologists). It was there, I used the toilet again and this time I was severely blocked for 5 seconds then an explosion of blood, blood clots and uriine. I couldn't see any stones because the toilet water was so red but I felt instant relief.

I then met with the urologists an hour later, one last time peed blood with another clot. Since then my urine looks normal and no pain or discomfort. Monday the 26th of Sept I went for an ultrasound---the bladder and the left kidney looked normal. Lab work report showed no signs of infection. (The ultrasound revealed my right kidney was one mass of contiguous cysts- this may be another story for later) I return this Monday 10/3 for a flexitube cystoscopy to rule in or out bladder cancer and other bladder issues. The urologists thinks the blood 'may' have been a long term side effect of my prostate radiotherapy on my bladder in February 2020 or even the effects of an expelled stone.

Good news is my PSA result is still less than 0.03 as it was last April.

Any insights welcomed .

Thanks

[old64horn in reply to Steve507]

I seem to be following the same path except I don't have any blockage. sometimes tere is just a trac e of blood and other times it is more concentrated and with few clots of blood

[Aljr2004 in reply to Steve507]

Steve - welcome to my world. When I can’t pee, a rage unbelievable builds up and then when the clots release I am as happy as a kid because another trip to the Urologist avoided. The problem with those clots - they eventually shut the bladder down and require catheter insertion.

[Steve507 in reply to Aljr2004]

Had a cystoscopy today. Bladder inflammation, scarring result of radiation in Feb 2021. Uro said will clear up on its own. Now onto my kidney function next week.

[Aljr2004 in reply to Steve507]

The Doc should have added a qualifier - for some, it clears up on its own, while for others, the problem can worsen.

[Steve507 in reply to Aljr2004]

Yea, he should

[Aljr2004]

old64horn - You need to keep a bleed log - chart when the bleeding occurs - time of day - and for good measure - keep photos. While LRC clears up for most, or is so infrequent it seems harmless, that is not true for all of us. I am 57 and average 10 days of bleeding per month. When the clots choose to, they shut the bladder down - no fun wearing a catheter and risk of infection from the catheter is far higher than Urologists will share. All of the blood loss you experience will not be visible to your eye and you can suddenly become anemic. Feeling drained impacts your ability to work so pay close to attention to your progression and change Urologist if your current doctor is dismissive

I have not been able to find a trigger - months off from exercise did not help, but each of us are different so your own efforts to manage this are crucial. I have never drank alcohol so multiple Urologists focus on consumption of alcohol as a trigger gets dismissed by me at the start.

[old64horn in reply to Aljr2004]

I started a log as you recommend. Sometimes the bleeding is more and few clots appear as well

[Explorer08]

I had blood in my urine several months ago. Urologist determined it was caused by a severe UTI staph infection, an unusual type of UTI. A 7-day course of Ceftin cleared it up and I've had no recurrence. (RRP 11 years ago. Salvage radiation in 2013. 55 weeks of Orgovyx ending last April.)

[TJS-1]

Had (having?) identical symptoms last July at 3yrs post full-pelvic IMRT. No pain or discomfort, but a little alarmed given no other longer term side affects from the radiation. 2 separate incidents 3 weeks apart lasted 6-10 hours each; lots of blood and clotting discharges each time I urinated for the 8-12 hour period. It then fully resolved on its own overnight. Each time it followed a longish bike ride (3+ hrs/50+ miles), so stopped riding for awhile and no recurrence since. MO indicated probably not a concern consistent with TA’s observation. Will do a cystoscopy at some point when we feel the scar tissue that caused those bouts is no longer an issue. Just an FYI to give some peace of mind.

[Steve507 in reply to TJS-1]

👍

[Aljr2004 in reply to TJS-1]

TJS - I too am a cyclist. Over 5000 miles last year- less than 3000 this year as i missed a number of months trying to determine if cycling was a contributor - definitely was not in my case as I bled as much or more during no exercise.

[leebeth]

No, we are in Wisconsin, and there are individual chambers. If it were me, I likely would have driven 45 min to Milwaukee to go to the open type. He said he was not claustrophobic though. It was spacious.

[Muffin2019]

Most have had that on occasion , i have had it about 3 times, once when not drinking enough water then taking a long walk. Was taking two medications with that side effect unless you drank enough water. The last time my cat stepped on the area of the bladder (he weighs 18 pounds) and was sore and passed a blood clot. The tumor in the bladder from prostate cancer is no doubt irritating the bladder but i am on chemo and the flow has improved, future scans will reveal if the tumor has shrunk and the liver lesions are healing or gone. We just fight on and do the treatments to extend our time on earth.

[Hidden]

once the bad stuff is ruled out, prostate, bladder, kidneys..... obvious answers is Radiation cystitis. And that can hit anytime even out to 29 years post radiation. I just went through a bout of gross hematura with blood clots from seeds and IMRT from 2003. Best to have a Urogram and Cystiscope to rule out bad stuff. Me, lobes of prostate growing, prostate enlarged..... will probably have an Urolift next year. This is normal.... Good luck....

GD

[Steve507 in reply to Hidden]

👍

[Steve507 in reply to Hidden]

Cystoscopy today revealed bladder inflammation, scaring result of radiation. Nothing too serious

[braunsballs]

Many years before I got PC, I peed what I thought was blood. Was leaving for Costa Rica in a couple of days so this freaked me out. Called my GP and he set up an appointment for some tests the next day. That night I remembered I had eaten a whole jar of pickled beets. LOL Called the doctor the next day and told him.....nevermind. Thought someone may think this was kind of funny. After radiation for PC I did get blood in my urine. Had a cystoscopy and he found scar tissue and a couple of small kidney stones. The blood went away on its own a couple of days later and has never returned. I think blood in your urine is pretty common for us guys that had radiation for PC.

[StePeteMN]

Me. This last week for one day--three pisses. I went straight to urgent care to get urinalysis and culture which were both negative. It was recommended to me that I bring it up with a urologist, which I will do, in Rochester, this next week. I have I have been on ADT for nearly five years and just completed 9 cycles of cabazitaxle and carboplatin. I blabe chemo for a lot of things.