Blood in urine

[LoveDrumming]

Hi all. This is my first post here. I had a robotic radical prostatectomy three months ago. In the first few weeks after surgery, my urine was clear, but then I started showing blood on my pads during walks. This has continued ever since and I'm now at 12 weeks after surgery. These are pink spots, not clots. It only occurs on a walk or rarely after a bowel movement - the rest of the day my urine is clear. My doctor says its all part of normal healing, but it worries me nevertheless because it just won't go away. Has anyone else experienced this long-term bleeding?

[Tall_Allen]

He might have nicked a blood vessel that requires cauterization. If it is copious and doesn't resolve, you may want to get a cystoscopy from a different urologist.

[LoveDrumming in reply to Tall_Allen]

Thanks Tall_Allen. I'll check into that option.

[Justfor_]

Did you have a cystography to verify anastomosis tightness before removing the catheter?

[LoveDrumming in reply to Justfor_]

No I did not. Is that routine? Do you think my bleeding will resolve?

[Justfor_ in reply to LoveDrumming]

Where I had my RALP it was, 5 years today. In the States they follow the cowboy's bravado style and don't mind checking, as far as I have learned from this forum. I hoped that Canada was closer to European practices than US ones.

Now, your doctor is a jerk and you better find someone else. It is NOT "normal healing" to witness "pink spots" into urine 12 weeks post RP. Pink tinted urine means that FRESH blood is leaking into it. If it were old, it would had been clotted and brownish to black.

You can follow Tall_Allen's advice for a cystoscopy, but it may prove painful. I had personally experienced anastomosis leakage and would propose another less invasive way to test. Let them place a foley catheter and watch the outcome. If your anastomosis is bleeding, blood will sip out on the OUTSIDE of the catheter tube and it will be red-purple, i.e. not mixed/diluted with/by urine. Urine will also be normal colour, i.e. not be tinted pink. In case urine keeps being tinted pink with the catheter in place, anastomosis shall be stricken out from the suspect list of hemorrhaging places, as the catheter bypasses this part of the flow.

You should also be very vigilant in noticing signs of infection, like fever, as a not completely healed anastomosis may be leaky as well. I have a horror story along these lines that I will not share.

[LoveDrumming in reply to Justfor_]

Thanks Justfor_ To be fair to my urologist, I reported my problem to my urologist at 7 weeks post-RALP at which point he said it was normal healing. It's now 12 weeks, so his opinion might change when I let him know the situation. I'll do that asap. Thanks also for the tip about the catheter.

[LoveDrumming in reply to Justfor_]

Did your anastomosis leakage show as a constant flow of blood? Day and night? Did it seem like a large volume? My bleeding problem is intermittent... only occurs when walking about 1 km or more. Also, it seems like its only a few drops, and then stops. Nevertheless, I'm taking everyone's advice and getting it checked out asap.

[Justfor_ in reply to LoveDrumming]

I had the catheter for almost one month before it proved safe to remove. Three cystographies, the two first failed, the third was ok and catheter was removed on the spot. I only had blood on the outside of the tube of the catheter. Only a couple of drops. I was monitoring it by wrapping a piece of toilet paper at the exit of the tube that occasionally was stained red. There wasn't a pattern to it, looked quasi-random. It would disappear for a couple of days, I was happy believing it was over and then come back after sleep which was the least active time period of the day compared to walking, passing stool etc. Urine was never tinted pink.

[LoveDrumming in reply to Justfor_]

Thanks Justfor_. I really do appreciate the extra info.

[Tire2222]

I’d get that checked out by another urologist- just to put your mind at ease. Just my opinion

[LoveDrumming in reply to Tire2222]

Ok, thanks for the advice.

[j-o-h-n]

Been there, Done that, Got the tee shirt to prove it.

It goes without saying.... but I'll say it anyway..... Of course you get shitless when you see Pink or Red in your underwear (Discounting Lipstick). Scares the hell out of me, but I call my favorite urologist Dr. Peekaboo and get to see him right away. He cystoscopes me and let's me know the prognosis, which is generally "Mr. j-o-h-n, the cause for the blood is... who the hell knows why?".

Joking aside: See a good urologist asap.

BTW Please update your bio with your pertinent Pca data (it's voluntary but it helps us and helps you). Thanks!!!

Good Luck, Good Health and Good Humor.

j-o-h-n

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

That seems to be the consensus here - to see a different urologist. But I'm going talk to my current urologist first, since it's been 5 weeks since he's had an update. Thanks.

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

No beating around the bush, drop the sticks....... and dial him/her right away...

Good Luck, Good Health and Good Humor.

j-o-h-n