Post Radiation Therapy - Blood in Urine

I am currently researching for my boyfriend, he is going through the same thing as you. It’s been years now, and still blood, and huge painful clots. He thinks they are worse when he does physical activity. You two really need to talk and try to help each other figure things out if possible. One of his doctors suggested that hydobaric oxygen. The other doctor told him that he thinks it causes the cancer to spread, because it happened to one of his patients. It could have just been coincidentally. We are confused and scared, but something needs to be done.

@lsk1000 would you please share the doctor who helped you with this please. Thank you so much! Sue Smith

I’ve written often about my 9 month battle with profuse bleeding from radiation cystitis two years post prostatectomy / radiation. Twice weekly blood clots, once a week they could not be expelled by urinating and cause urinary retention. The anxiety every time I went to pee was debilitating. I got tired of all the doctor and ER visits to irrigate the bladder so I did it myself at home by squirting a syringe filled with sterile water and 5% hydrogen peroxide into the bladder with a tiny 10 French catheter to push the clots away from the bladder opening and force them to explode out. A dicy procedure.

Took 72 sessions of HBOT with zero results. Finally found a urology surgeon who would do a bladder fulguration and a chemical instillation of an agent called Amicar. (There are many different chemical agents). Amicar worked for a month. Then we switched to ALUM which did the trick, put the bleeding at bay going on 3.5 years. I never experienced relief to such an extent as when the bleeding finally was addressed.

I had proton radiation for prostate cancer 15 years ago. Now I am bleeding about every 3 weeks a couple of times in one day when I pee.
I had a scope about 2 years ago and the urologist said it was wall damage in the bladder from the radiation treatment .
Since blood is more frequent now than it was a couple of years ago, and there is an occasional small chunk of blot material, what should be my next step? Just keep on trucking or get another scope?

My experience has been very similar to that posted by hector13. I had robotic surgery to remove a malignant prostate in 2007 (age 62) but my PSA started to rise again in 2018. I had 39 radiation sessions in 2018 focused on the area where prostate was removed which reduced PSA from 0.13 to 0.01 to 0.03 range where it remained the last time it was checked in early 2025. In May 2024, six years after radiation I started periodically seeing blood and small clots in urine. Sometimes it would be months between episodes. On one episode (while on Eliquis) a large blood clot plugged my urethra requiring an emergency room visit and a foley catheter to clear the blockage. My urologist did a cystoscope to check the bladder and found no issues. He said that it was probably from some damage to my urethra and offered no resolution. Now about 18 months after it started, I still have periodic relatively small amounts of blood in the urine and sometimes will pass clots. The latest was a relatively large clot that passed today after months of all clear. I'm wondering whether excessive straining or exercise might be a trigger.

I am updating my original post for this topic. I think it is an important issue that the administrator for the site should consider for one of the monthly Zoom briefings. When we are asked to consider radiation treatment, we hope it will kill all the prostate cancer and effectively cure our cancer. Often, this is not the case. Not only does the prostate cancer return, the radiation damages our bodies in different ways for years to come. Are the radiation centers actively working on procedures to better protect vital organs during radiation treatments?
Having said that, in my particular case several months after completing radiation therapy I experienced significant bleeding when I urinated (which caused a lot of discomfort) as well as when I had bowel movements. My bladder and rectum had been scarred by radiation. I was fortunate that I was quickly approved for oxygen therapy; there was a wound center about 10 minutes from my house with four hyperbaric oxygen chambers. I had 40 sessions with pure oxygen which eventually stopped all symptoms of bleeding. Oxygen therapy is very expensive; my insurance covered most of it, but I had to pay the rest. The other drawback pertains to vision. The doctor in charge of the wound center advised me that my vision would be negatively affected and he was right. I had to wait 6 months to get my prescription glasses changed.
So back to my current issue, On Monday this week during urination I passed a large solid item about 1/3 inches long. I believe it was a piece of my bladder that was the cause of my bleeding for several days, and ever since it passed the blood in the urine has stopped. I think this may be the pattern of radiation cystitus, that once the damaged bladder loses a piece, it produces bleeding in the urine until it is able to pass. I hope this never happens again, but if it does, I will have a better understanding of what is causing it.
If any other men have had periodic bleeding that ends upon passing solid matter, I would be interested in hearing your experience. Of particular interest are cases where a number of years has passed before any bleeding occurs following radiation therapy. For me it happened 5 years after my radiation treatment ended.
I would welcome any negative experiences of what you fellows have gone through after radiation therapy. This is an important topic.