Post RT, blood in urine etc, any ideas?

User

Posted 03 Sep 2015 at 22:32

Hi Guys,

I haven’t posted for some time, because everything seemed to be going so well, and I enjoy those periods when I can try and forget about PCa. However I seem to have taken a turn for the worse and your wise thoughts will be appreciated.

I was initially diagnosed back in 2007, had conventional RT in 2009, PSA started climbing again in 2013 and so I had salvage HDR brachytherapy in February.

During April, May and June everything seemed good, I had regained full continence and was urinating easily without problems. But as July became August I started to notice occasional blood in urine, sometimes small clots, more often red/pink urine. Urination has become increasingly difficult, sometimes painful, a sporadic and weak flow often only a small amount followed by the need to urinate again within a few minutes.

I have never had surgery to the waterworks system so we can rule out scar tissue issues.

I am due to see Consultant next week for 6 monthly checkup, any ideas what I should be asking or what do you think is going on?

Dave

User

Posted 04 Sep 2015 at 07:33

Hello Dave
Sorry you are having problems.

Would it be good idea to see the GP and rule out any infections?

We can't control the winds - but we can adjust our sails

User

Posted 04 Sep 2015 at 08:02

Sorry to hear that, Dave,

I read your previous account of your brachy with interest.

What about giving Mt Vernon a ring? (that's making an assumption that you haven't already done so). It may well be something they've encountered before and could turn out to be a short-cut, rather than waiting for the consultant's wheels to grind.

Best wishes for a speedy resolution.

Dave

Not "Why Me?" but "Why Not Me"?

User

Posted 04 Sep 2015 at 09:25

Hi Guys,

Thanks for your thoughts, I should have said that I went to GP last Friday, she tested urine, her indicator sticks confirmed blood in urine but didn't show urine infection. As it was the bank holiday she put me on antibiotics to be on the 'safe side', however when results came back from lab on Wednesday, they confirmed no urine infection.

Last night wasn't good, got up several times and only managed to squeeze out a few drops, but this morning after three attempts I finally managed a half hearted piss, which shows I haven't seized up all together!

I had a similar experience a few years ago, with post PLND lymphoceles (see my profile for detail), and after they cathetered me they kept me on Urology ward for several days where I caught a whole array of urine infections. So this time my aim is to avoid being admitted to hospital.

I had been determined to get myself fit and continent by my own efforts, and so resisted suggestions that I go on that medication which relaxs the sphincter, but I think you can get it over the counter at chemists, so I am tempted to try it and see if it helps? At the moment I am thinking if it gets me through the weekend and I avoid the hospital that will be a result!

Dave

User

Posted 04 Sep 2015 at 15:47

Dave

after your previous experience at the hospital I understand your reluctance to have to go back.

If you are having times when you just can't go, weak flow and blood in your urine which is sometimes clotted you definitely have a problem that needs checking out.

I am not a medically qualified person so would not presume to try and give an opinion on how urgent or not that might be, however even though a urine infection has been ruled out that still leaves several other possibilities.

These include urine retention in the bladder (even partial) a partial blockage or restriction somewhere in your waterworks or a possible problem elsewhere in the general local including in the prostate itself. It is quite common for the urethra to become squeezed in PCa, that can sometimes be eased by medication although it can also ultimately require surgical intervention like a TURP.

Things to consider are When you do manage to go is the urine dark and strong smelling or just normal?

Do you feel lke you really need to go but just cannot? Are you getting constant or increasing pain?

Are you still drinking plenty of fluids (water in paticularly) etc.

If you are in no pain and actually outputting a reasonable amount of urine in small but frequent wees and feel ok in yourself then it may be OK to wait until you see the consultant next week. If you start to get sweaty, have any significant pain or more persistent bleeding or find that you cannot urinate within a maximum 12 hour period then do not let previous issues deter you, get into A&E and get it checked out. If you do not empty your bladder sufficiently and urine starts to backflow back up to your kidneys that can be very serious indeed.

If you feel you are genuinely ok to wait and see the consultant then make sure you let them know every little detail.

I wish you all the best

User

Posted 04 Sep 2015 at 20:10

Dave it's all very well trying to self-medicate but if you go into full urine retention, you risk permanently damaging your kidneys. You could try the following for a couple of days to reduce the irritation: avoid all alcohol and caffeine, avoid citrus fruit juices, drink lots of cranberry juice instead.

As you have had PCa in the past, and had brachy, I think it would be a very irresponsible pharmacist that would sell you alfuzosin / xatral over the counter. Do the right thing and check with your doctor or nurse specialist just in case.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 04 Sep 2015 at 22:06

Dave,

Back in December 2012 I ignored the fact I couldn't wee, I had ache in my back, went to GP who diagnosed acute urine retention and sent me straight to A&E where they catheterised me immediately. Problem affected my kidneys - see my profile for more details and my treatment.

From my own experience I advise you not to leave this too long.

Arthur

User

Posted 04 Sep 2015 at 22:11

Hi Lyn and Mo,

Thanks for showing interest, I was at a bit of a low ebb, when I posted this morning, the day has been far more succesful.

I am no longer a strict adherent of the Jane Plant diet but follow it where I can, and I have retained what is almost an addiction to Green Tea, so my kidneys have been well flushed today with plenty of green tea.

I don't know if the other guys experience this, but whenever I go to sleep, my bladder seems to go into lockdown mode, so when I awake urination is a long drawn out affair with many failed attempts, but usually, as today, I get there in the end, when my bladder has finally woken up!

My appointment with the Consultant is on Monday morning, so finger's crossed I should be able to muddle through till then.

Dave

User

Posted 04 Sep 2015 at 22:27

Dave

Don't muddle through. It seems to me you need urgent attention. Don't let the previous experience put you off, because doing nothing all weekend could be far more disastrous.

Paul

Stay Calm And Carry On.

User

Posted 05 Sep 2015 at 12:02

Dave,

We've known eachother a long time, and I've always tried to give you good info.
This time is no exception.

You MUST get this sorted.
Too many of our friends have suffered terrible pain and trauma after allowing retention to continue.

You need this blockage cleared a.s.a.p. Good luck, and please keep us updated.

All the best,

George

B2PCa

User

Posted 05 Sep 2015 at 12:33

Dave

When first on the site you mentioned a fare few times of falling of your perch, I’m pleased to see you’re still sitting on it. Many have known you for a long time and want to continue doing just that so do take heed of the advice.

As regards bladder lockdown – in my dreams http://community.prostatecanceruk.org/editors/tiny_mce/plugins/emoticons/img/smiley-smile.gif as it seems my bladder doesn’t want to get to sleep.

Take care Dave

Ray

User

Posted 05 Sep 2015 at 13:36

Ray,

You and I have the same problem.

Oh for a good night's sleep!http://community.prostatecanceruk.org/editors/tiny_mce/plugins/emoticons/img/smiley-frown.gif

If anything my nocturnal loo trips are increasing, every few hours overnight I have to stumble to the loo.

But hey, we can live with it. Far better that than retention, innit?

George

B2PCa

User

Posted 05 Sep 2015 at 17:41

It sure is George. I've had 1 nights sleep since treatment started. That was down to drinking more than I should have.

Whilst you're here George I've got some bad news for you as one of my grandkids is heading your way soon. Why sunny Southampton was rejected in favour of rain soaked Newcastle to train to be a doctor beats me. Something about liking the folks up your way - on that basis a wise choice :)

Keep going well - that 11 years is getting ever nearer :)

Ray

User

Posted 05 Sep 2015 at 18:38

Hi Ray, George and all,

I am pleased to say that I am doing OK during the day, and only two more nights to get through until I see my Consultant.

Regarding your troubles, what I have noticed is that nine nights out of ten, I sit watching telly with the missus, sipping Green tea all evening, then I am up 2, 3 or more times in the night for a pee, usually a half hearted attempt at a pee, more of a dribble.

But a couple of times a month I let my brother drag me off down the pub, 3, 4 or more pints of Guiness, topped up with a couple of pints of kingfisher to wash down the Vindaloo. Then I sleep like a log, right through the night, and when I wake in the morning I piss like a horse.

I am not going to try it tonight as I am currently too delicate, but for those of you more robust chaps, Guiness and Kingfisher might be the best perscription for a good night's sleep?

Dave

User

Posted 07 Sep 2015 at 14:49

Hi Guys,

I thought you may like to know what the consultant said:

The tenderness and blood in urine etc is due to a prostate infection, (as opposed to urine infection which I tested negative for).

So he has put me on Ciprofloxacin for 6 weeks.

He has also put me on Tamsulosin for urinating issues, he tells me that I will be on that for the rest of my life, but he has only given me 30 tablets!

Dave

User

Posted 07 Sep 2015 at 15:19

Hi Dave

It’s good that you have got an opinion on your problem and you are now on Cyprofloxacin for 6 weeks.

As for getting only 30 Tamsulosin tablets I think your hospital letter to your GP, copied to you if you asked for a copy, should explain that your GP will give you ongoing prescriptions for Tamsulosin.

I hope things improve for you.

Regards

Alan

User

Posted 07 Sep 2015 at 15:57

Thanks for the update Dave. Well at least you know, not so bad. I've been on various pills besides Tam that are designed to do the same job. I thought my GP was being over cautious when he said no to coming off them. Did your consultant say why for life?

Hope you last longer than the prescribed 30 days :)

Ray

Edited by member 07 Sep 2015 at 15:58 | Reason: Not specified

User

Posted 07 Sep 2015 at 17:21

Dave my John was given about a months supply and then had to get the rest from our GP who made no fuss about supplying them.

We can't control the winds - but we can adjust our sails

User

Posted 07 Sep 2015 at 20:37

Thanks for the update Phil.

That's shed new light on the issue.

As for Tamsulosin capsules, I have never stopped taking them since my RT in 2005.
At first I needed two a day, but for many years one has been enough.

I hope everything clears up well for you.

George

B2PCa

User

Posted 08 Sep 2015 at 07:46

Hi Guys,

Thanks for the kind words, I had forgotten quite how supportive it is to have fellow travellers sharing their experiences, so I promise not to be a stranger any more.

To finish on an upbeat note, the Consultant also said that my next Prostrap injection in December can be my last, for the time being.

So next year I shall be off the HT, flying blind, it will be interesting to see what happens to my PSA this time, I am working on the rule of thumb that post treatment PSA should broadly match the years since HT, ie PSA of 2 is OK for the first to years, up to 4 after 4 years off HT, always assuming I last that long?

Dave

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