1. < Prostate Cancer

Prostate cancer with hematuria (blood in urine): How to make it stop?

Posted by prostatecancer123 @prostatecancer123, Apr 26 10:00am

I am a 75-year-old man. I was diagnosed with prostate cancer in November 2021. I had the LDR brachy therapy in May 2022. The procedure went well, and I had not had any side effect. However, since October 2023, I have had blood in my urine intermittently, some time is worst then the other. In April of this year, my urologist performed cystoscopy and examined the prostatic urethra. The procedure revealed active capillary bleeding at the 9 o'clock position on the bladder neck towards the right side. Then he prescribed Avodart (Dutasteride). I have been taking Tamsulosin shortly before the brachy therapy. It seems working quite well, but my urine still has intermittent blood. In the meantime, my PSA is 0.04 ng/ml, down from 6.5 ng/ml prior to the LDR brachy therapy. I wonder what I should do to stop the hematuria. Does any prostate cancer survivor have such experience? Please advise me!!!

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

Moderator
Colleen Young, Connect Director | @colleenyoung | May 5 3:05pm
In reply to @prostatecancer123 "Thanks for the very good advice, Mr. Nothoftheborder. I normally drink 2 or 3 64 oz..." + (show)
@prostatecancer123

Thanks for the very good advice, Mr. Nothoftheborder. I normally drink 2 or 3 64 oz cups (Double Gulp) of water every day. I believe my body still needs more.

Jump to this post

@prostatecancer123, if you would like to seek a second opinion from Mayo Clinic experts, you can submit a request here: http://mayocl.in/1mtmR63

You may also appreciate the tips shared in this related discussion:
- Post Radiation Therapy - Blood in Urine
https://connect.mayoclinic.org/discussion/post-radiation-therapy-blood-in-urine/

Has anything changed since your last posting here? How are you doing?

REPLY
prostatecancer123 | @prostatecancer123 | Apr 28 11:40am

Thanks for the very good advice, Mr. Nothoftheborder. I normally drink 2 or 3 64 oz cups (Double Gulp) of water every day. I believe my body still needs more.

REPLY
1 reply
northoftheborder | @northoftheborder | Apr 27 6:03am

The best advice I got was to stay well hydrated: the urinary tract gets more irritated when it's dry.

My first hematuria was right after a week-long vacation — a year after SBRT to my prostate — when I hadn't drinking nearly as much water as I normally would at home.

There are still likely traces of blood, but they're no longer visible to the human eye as long as I have a few big glasses of water every day.

REPLY
prostatecancer123 | @prostatecancer123 | Apr 26 2:22pm
In reply to @predictable "Thanks @prostatecancer123 for the detailed and technically impressive report on your experience with hematuria. I cannot..." + (show)
@predictable

Thanks @prostatecancer123 for the detailed and technically impressive report on your experience with hematuria. I cannot imagine any helpful suggestions for you, other than these two: 1) a secondary opinion from a well known urologist and/or 2) applying to a comprehensive medical system such as at a state university medical college or an established nonacademic institution such as the Mayo Clinic. Your blood specimens seem to differ more than I find easy to comprehend. Could capillary bleeding (which I also had after a TURP procedure several years ago) cause so many types of blood to emerge? Martin

Jump to this post

Thanks again, Mr. Jensen. My urologist is a very well-known one in where I live. But I am tempted to visit the Mayo Clinic for a second opinion as you suggested.

REPLY
Martin Jensen, Volunteer Mentor | @predictable | Apr 26 12:34pm
In reply to @prostatecancer123 "Thanks for your response, Mr. Jensen. My blood comes in several forms, with my best ability..." + (show)
@prostatecancer123

Thanks for your response, Mr. Jensen. My blood comes in several forms, with my best ability to describe it: 1) A flake size in clear urine, 2) pale red blood that is diluted by urine, 3) pulp form of clot blood not being diluted by urine, and 4) dark red blood mixed with my urine that looks like the color of coke soda. And of course, there is always microscopic form that I could not see with my naked eyes except using a urine test strip. They come once then gone for days or couple weeks. However, it appears more often lately. When the hematuria first started in last October, a CT scan with and without contract was performed on my abdomen. Results were normal with the exception of a kidney stone at an un-obstructing location. Also, I have no pain in my back or side part of my body. So, the urologist concluded that the hematuria is not caused by kidney stone but concluded that the capillary bleeding could be caused by LDR brachy therapy. He also did a KUB and saw the kidney stone is small ~3mm. A six-month following up was recommended.
prostatecancer123

Jump to this post

Thanks @prostatecancer123 for the detailed and technically impressive report on your experience with hematuria. I cannot imagine any helpful suggestions for you, other than these two: 1) a secondary opinion from a well known urologist and/or 2) applying to a comprehensive medical system such as at a state university medical college or an established nonacademic institution such as the Mayo Clinic. Your blood specimens seem to differ more than I find easy to comprehend. Could capillary bleeding (which I also had after a TURP procedure several years ago) cause so many types of blood to emerge? Martin

REPLY
1 reply
prostatecancer123 | @prostatecancer123 | Apr 26 12:08pm
In reply to @predictable "Hi, @prostatecancer123. My bladder and prostate deficiencies involve incidents of hematuria once or twice a year...." + (show)
@predictable

Hi, @prostatecancer123. My bladder and prostate deficiencies involve incidents of hematuria once or twice a year. The blood comes in two forms: 1) A pea-size blood clot on one or two days and 2) pale red blood in my urine for a couple of days. My urologists have advised me not to regard that hematuria as serious unless the blood is "gross" or "frank" (as though not diluted by urine). Mine has been that way for 10 years or more, so I report it to my urologist at my annual exam and receive reassurance that it remains tolerable. You didn't detail the nature of your hematuria, so you might want to talk with your urologist about that and ask for guidance on what steps to take when blood appears in your urine. Martin

Jump to this post

Thanks for your response, Mr. Jensen. My blood comes in several forms, with my best ability to describe it: 1) A flake size in clear urine, 2) pale red blood that is diluted by urine, 3) pulp form of clot blood not being diluted by urine, and 4) dark red blood mixed with my urine that looks like the color of coke soda. And of course, there is always microscopic form that I could not see with my naked eyes except using a urine test strip. They come once then gone for days or couple weeks. However, it appears more often lately. When the hematuria first started in last October, a CT scan with and without contract was performed on my abdomen. Results were normal with the exception of a kidney stone at an un-obstructing location. Also, I have no pain in my back or side part of my body. So, the urologist concluded that the hematuria is not caused by kidney stone but concluded that the capillary bleeding could be caused by LDR brachy therapy. He also did a KUB and saw the kidney stone is small ~3mm. A six-month following up was recommended.
prostatecancer123

REPLY
1 reply
Martin Jensen, Volunteer Mentor | @predictable | Apr 26 11:11am

Hi, @prostatecancer123. My bladder and prostate deficiencies involve incidents of hematuria once or twice a year. The blood comes in two forms: 1) A pea-size blood clot on one or two days and 2) pale red blood in my urine for a couple of days. My urologists have advised me not to regard that hematuria as serious unless the blood is "gross" or "frank" (as though not diluted by urine). Mine has been that way for 10 years or more, so I report it to my urologist at my annual exam and receive reassurance that it remains tolerable. You didn't detail the nature of your hematuria, so you might want to talk with your urologist about that and ask for guidance on what steps to take when blood appears in your urine. Martin

REPLY
1 reply
Please sign in or register to post a reply.