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Blood and blood clots in urine two years post radiation
I am two years out from prostate radiation. No post treatment blood in urine (beginning of stream) until after February of this year 2026 after going on daily baby aspirin.
3 times in February / March then nothing until recently (August 2026). Blood and clots at beginning of stream. I’ve been hesitant to make appointment with urologist for evaluation and cystoscopy. I know I should do this but I’m dealing with a malignant lung nodule and treatment options and just dont have the energy to be scoped out.
My AI research (I know…) and what i have read on this forum says about two years out is not unusual for late radiation cystitis (typical late tissue changes) with small blood clots. Particularly if just starting daily baby aspirin which acts as mild blood thinner. Frm what Ive read, radiation causes gradual changes to the lining of the urinary tract and the prostatic urethra. Over time, the blood vessels in these areas can become fragile, leading to minor, intermittent bleeding.
Why it happens at the start of the stream: Blood or small sloughed tissue/clots that have pooled in the prostatic urethra or near the bladder neck tend to be flushed out first when you begin urinating, followed by clear, normal-looking urine.
I’m also reading that while radiation-induced tissue changes (aka, late radiation cystitis or urethritis) are a primary suspect, visible blood in the urine (gross hematuria) always requires a thorough evaluation by your radiation oncologist or urologist. It is essential to rule out other potential causes, such as a localized infection, kidney or bladder stones, or new changes in the bladder or urinary tract lining.
Because this started after going on daily baby aspirin (makes fragile, radiation-treated blood vessels in the prostate and bladder lining much more prone to oozing or leaking blood into the urinary tract) and so far has been only occasional snd not inconsistent with others here on the forum experiencing similar issues, i’m inclined wait and see.
So I guess my question is, has anyone else experienced this and taken a “wait and see” approach with no really bad outcomes from that decision?
Thank you and best wishes your journey. Radiation combined with ADT (Lupron) for 18 months wasn’t fun but like everything else, you just get it done. There are do many things that are much worse. I thank God for my good health and good doctors, nurses, staff and facilities.
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Who prescribed the baby aspirin? Do they know it has caused hematuria (maybe in combination with prior radiation)? Has anyone recommended stopping the baby aspirin? Never had hematuria but have been on baby aspirin for years. Had to stop a few weeks after radiation due to conflicts with medications for acute side effects. Bleeding primarily from sinuses. Was able to resume aspirin after the side effects abated and medications discontinued.
@jim18 My vein specialist doctor, but i dont recall prior radiation treatment being discussed. He detected small amounts of plaque and prescribed Rosuvastin snd baby aspirin.
Im going to text my PCP tight now and see what he thinks about stopping the aspirin. Thank you so much for the comment.
Hemorrhaging bladder cystitis post radiation was the absolute worst experience of my life and I’ve been through some real doozies. It started out innocuously, but the clots eventually got larger and caused urinary retention (painful) which had to be expelled by urinating if lucky of by irrigation by a doctor, nurse, or self-irrigation. I have a photo of a blood splattered shower after self-irrigating. I keep it to remind me how fortunate I am to be over it. It lasted 9 months, everyday met with abject fear and anxiety the pee wouldn’t flow. The cure after 74 sessions of ineffective Hyperbaric oxygen, fulguration, and Amicar bladder instillation was the instillation of a chemical agent called ALUM.
I suggest clotting not be ignored despite feeling overwhelmed with a second medical issue. I’m reminded of sitting in the infusion room getting chemo for my first cancer before prostate cancer. A woman mentioned she was diagnosed with a second cancer. Hearing that I thought to myself I would completely fall apart having to deal with a second cancer, yet here I am doing just that. Hope you can get it resolved expeditiously.
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3 ReactionsWow. I’m glad to hear you are in that “looking back on it” stage. Your story has pretty much convinced me to go get bladder scoped. Rather than wait and see.
May I ask about how long after radiation your severe clotting began and if you waited awhile before getting scoped? Do you think the clotting might have been more treatable or manageable had you gone back to your urologist sooner? Thanks for sharing your experience.
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1 Reaction@larry1443 One additional question if you font mind. Fid you ever find out the cause of your severe clotting vs. the more typical stories about late radiation cystitis?
@larry1443, I'm tagging @lsk1000 so that he sees your questions.
Larry, have you been to see a urologist in the meantime?
@lsk1000
My Dad is going through this right now. He had prostate cancer 8 years ago and started experiencing your exact situation 1 year ago. It’s been pretty bad in last month with 4 ER visits due to urinary retention due to blood clots.
Would you suggest discussing Alum treatment with his urologist ? How long have you been free of the cystitis?
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1 Reaction@larry1443 If memory serves me the a small amound of blood leaked out two years after post-prostatectomy salvage radiation. A few months later, suddenly the bleeding worsened and the clotting. At that point I sought medical attention immediately.
I am unaware what a urologist could have or would have done when the first drops of blood appeared. Some people rush to a doctor or emergency room at the slightest provocation. Some like me wait until it’s serious, or evident it won’t resolve itself.
FYI: I also had a urethral stricture caused by the radiation so I couldn’t get scoped. Totally blocked.
@colleenyoung When the clotting began I sought medical attention. Initially when the clots could not be pushed out by peeing, I had several urologists and nurses irrigate the bladder to extract them. Eventually I was able to self-irrigate. A solution was found after nine months of physical and emotional tumult. .
@larry1443 There was no doubt in anyone’s mind it was the radiation, which by the way caused the urethral stricture as well.