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Bleeding and Urinary Blockage after TURP

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Posted 10/9/2022 9:06 AM (GMT -5)
*** Just joined and re-posted from Cancer Survivors Network hoping to reach out to more people who can help u****

My husband had the GreenLight Laser procedure for BPH three weeks ago. He is not recovering at all, with two major problems (100% urinary blockage and continuous bleeding). We are extremely stressed and need any help we can get.

For reference, my husband (70 yo, active and in very good health) has localized prostate cancer with Gleason sore 4+4=8. He is not suitable for RP because of easy bleeding (low platelets, in the range of 90-130) and is going for RT and ADT (ADT three months -> RT -> ADT 15 months). He started ADT six weeks ago. Since he has moderate BPH problem, RTO suggested he improve BPH problem before RT. GreenLight Laser procedure was suggested by the urologist/surgeon after my husband tried several BPH oral medications and had side effect (dizziness).

1) My husband is being treated at one of leading cancer centers. Consulted with a hematologist prior to the GreenLight procedure with no issue.

2) He had the procedure three weeks ago, stayed overnight at hospital and discharged the next day. Everything was normal at that time.

3) However, he wasn’t able to pass urine that night and went to local ER to put a Foley catheter in (swelling was the reason given).

4) Catheter was removed after one week. He was able to urinate on his own for one and half days then it was blocked again. Went to local ER to put another Foley catheter in (blood clot was the reason given).

5) During the whole time, bleeding continued, same urine color (fruit punch) as the next day after surgery.

6) Catheter stayed in for two and half days. At the time of catheter removal, urologist/surgeon said it’s likely caused by blood clots and gave us instructions for self catheterization just in case.

7) Very unfortunately, my husband needed to self catheterize immediately after getting home on that day. He did that for one week but the situation (both bleeding and blockage) was not improving.

8) Urologist/surgeon flushed the bladder last Friday in his office and there was no blood clots found. Another Foley catheter was put in hoping that catheter can stop bleeding. Surgeon didn’t share with us what would be the next step if this fails.

9) It has been another two days, my husband drinks a lot of fluid and is afraid of moving his body but we don’t see any improvement.

Swelling should have come down. Urine culture test has ruled out urinary tract infection (UTI). There’s no blood clots found. What could be the reason for continuous bleeding and why he can’t pass the urine at all?? We are so so so worried and don’t know what to do, what to expect.

Sorry for this very long post. We are really desperate… and appreciate your input.
Posted 10/9/2022 12:47 PM (GMT -5)
That has to be very discouraging for your husband. It’s hard to tell exactly what might be causing the bleeding and inability to pass urine. And it sounds like they haven’t tried antibiotics yet. In 2021 I had to go to the local ER 2 1/2 times for a catheter and it was not fun at all. My problem was caused by an infection caused by procedures like a cystoscope and then a procedure called ureteroscopy. The 1/2 half of an ER visit is when I was able to drive to the urologist office and they put in a catheter.

Tell your husband to hang in there and hopefully they will have it figured out soon. One of the other people on third forum made a comment not long ago, and said the more that they tinker around down there the more likely you are to have problems. I haven’t gone to the urologist office at all this year and I haven’t had to go to the ER either.

Welcome to HW and hopefully some of the others will chip in soon.
Michael
Posted 10/9/2022 1:11 PM (GMT -5)
Hi Summer99, so sorry to hear of your husband’s problems. I had laser surgery in readiness for radiation, so I understand the thought process. Mine was problem-free, though. A HoLEP procedure.

In your case, i expect they will want to do a cystoscopy. Use a scope to actually see where he is clogging up and bleeding. It would seem that that is next up.

This page has some food for thought…
Posted 10/9/2022 2:20 PM (GMT -5)
Thanks for your reply. This has been very stressful three weeks for us especially the last one. Each time we were hoping the "new fix" would work. We tried and waited but repeatedly hit by great disappointment. The urologist will not see us until Friday. I am afraid that eventually my husband has to go thru another cystoscopy just to find out what is going on there. Will anything invasive be needed after that giving he is still bleeding? Can the investigation be done by an MRI instead?
Posted 10/15/2022 3:40 PM (GMT -5)
My husband had a cyctoscopy yesterday. One bleeding spot may be the culprit. After doctor cauterized it symptoms seem to be improving but we are cautiously optimistic about it. Since my husband had been using catheters for almost four weeks, he has no bladder control after the catheter was removed yesterday. He has the urge to go but before he reaches the bathroom urine just leaks out and it's not enough to empty the bladder. He has the urge once every 30-60 minutes that makes sleeping at night very challenging. He wears Depend pad but he cannot pee while lying down. We understand it takes time to train the bladder to regain some of its ability. In the meantime, does anyone have coping experiences for sleeping? Your input is very much appreciated.
Posted 10/15/2022 10:59 PM (GMT -5)

Summer99 said...
We understand it takes time to train the bladder to regain some of its ability. .


Summer, your husbands case is different than mine, but I had my own trial with the bladder readjusting following laser surgery. I had some full-on Overactive Bladder (OAB) where I’d get crazy bad urges to go, and when I went there would be chills and some odd pain following. There were accidents that were demoralizing. Bleh. I wondered if this was my new normal, but about 80 days in the OAB started fading, and it is gone now. Yay.

My point being that while what your husband has is different, for sure it just flat out takes time for the system to adjust. So I would be targeting 3 months out to see where he ends up, knowing that whatever he is dealing with now is transitory. One foot in front of the other.

Best of luck!
Posted 10/16/2022 10:12 PM (GMT -5)
centralPAdude, thank you for sharing your story. You gave us hope that things can improve later down the road. The latest update is that the cyctoscopy procedure he had on Friday didn't help. He is back on catheter and bleeding continues. Needless to say we are very disappointed. One day at a time we are hanging here.
Posted 10/17/2022 6:36 PM (GMT -5)
After my prostatectomy, I had problems with retention and multiple trips to the ER. I ended up having a catheter for weeks. At the end of that time, I had no control of my bladder and had to use pads. But I kept up the kegels and after 10 months I was fully continent. It takes time! I don't have any insight into the issue of not being able to void while lying down.
Posted 10/25/2022 6:34 AM (GMT -5)
Had a cystoscopy. It cleaned up the free floating debris from previous procedure and solved the blockage problem. We are happy this is behind us now.
Posted 10/26/2022 6:43 PM (GMT -5)
That’s awesome news Summer99!

Full speed ahead…
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