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What Causes Bleeding During Urination After A Transureathal Resection?

Posted on Wed, 30 Jul 2014

Question: I RECEIVED A TRANSUREATHAL RESECTION OF THE PROSTATE (TURP) A FEW YEARS AGO. EVER SINCE I HAVE PERIODICALLY BLED WHILE URINATING, SOMETIMES TO THE POINT OF HAVING TO GO TO THE EMERGENCY ROOM FOR A URETHA TO UNCLOG THE BLOOD CLOTS (TWICE) AND ALMOST TO THAT POINT SEVERAL MORE TIMES. MY PHYSICIAN PRESCRIBED AVODART WHICH DID STOP THE BLEEDING BUT HAD UNACCEPTABLE SIDE EFFECTS. WHAT SHOULD I DO?

Answered by Dr. Dr. P. T. Patil (8 hours later)

Brief Answer:
Cause of bleeding needs to be evaluated.

Detailed Answer:
Hello
Thanks for your query,based on the facts that you have posted it appears that you have undergone surgery for enlarged Prostate (TURP0 few years ago and since then you had repeated episodes of bleeding per urethra .

I shall be happy if you can post me few more details to help me in making comments on your problem.
1) Do you have any urinary symptoms like frequency of urination.urgency,nocturnal frequency etc suggestive of enlarged prostate?
2) Was specimen of resected prostatic tissue sent for histopathological examination after TURP surgery.and what was the report ?

The hematuria that you have could be due to one of the following three reasons.
1) Prostate might not have been resected completely during surgery(TURP).
2) Recurrence of enlarged prostate
3) Cancer of the prostate.

Please consult qualified Urologist for clinical and digital rectal examination and get following basic tests done to find out the cause of bleeding.
1) Routine urine tests
2) Ultrasound Scanning of Abdomen.
3 Trans Rectal Ultrasound Scanning (TRUS)
4) Blood test for Serum PSA.
5) Endoscopic examination of bladder and prostate (Cystoscopy) if required.

Further treatment will depend upon the results of these tests and final diagnosis.

Hope I have answered your query ,please feel free to ask if you have more questions ,
I shall be happy to help you
Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Dr. P. T. Patil (3 hours later)

In response:

1. The TURP specimen was cancer free and subsequent examinations were also cancer free.

2. I am scheduled to be seen today in one hour. Will let you know the results.

Answered by Dr. Dr. P. T. Patil (1 hour later)

Brief Answer:
Please feedback about opinion and further plans.

Detailed Answer:
Hello
Thanks for follow up.Please do write to me about clinical findings and results of the tests which your Urologist conducts.

Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. P. T. Patil (33 hours later)

I am now scheduled for all remaining tests on Monday.

When you say that the prostate might not have been resected completely during the TURP does that mean total or partial removal? I thought TURP meant only removing the tissue that surrounds the uretha.

If the prostate has grown again which type of procedure would you suggest be done??

Answered by Dr. Dr. P. T. Patil (14 hours later)

Brief Answer:
Please read detail answer bellow

Detailed Answer:
Hello
Thanks for follow up.
In TURP surgery we resect adenoma a benign tumour that develops in Prostate and not the normal gland .One gets bleeding in immediate post operative period if the resection is incomplete .

However bleeding after a long period suggests recurrence of adenoma which is common after a period of 7-10 years.

If you have recurrence of enlarged prostate proved on ultrasound scanning you will need TURP again.

Thanks and Regards.
Dr.Patil.

Note: Consult a Urologist online for consultation about prostate and bladder problems, sexual dysfunction, kidney stones, prostate enlargement, urinary incontinence, impotence and erectile dysfunction - Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar