Thursday, August 25, 2016
Massive quantity of blood in urine
I am a 75 years old male with type 2 diabetes, COPD and diagnosed with Stage 2 urinary bladder cancer April 10th this year. The tumor was surgically removed by cystoscopy and I have had 2 cycles of Gemzar chemo therapy thus far.
I was urinating almost pure blood and huge blood clots over a several week period prior to the surgery. Often, I had difficulty expelling the blood clots. A few days after surgery, the bleeding stopped and my urine seemed normal. Yet, I have a high pus cell content and have had for almost two years. Three weeks ago it was TMTC (Too Many To Count). Had a culture done (as had several times the last two years) and a new antibiotic. After 10 days, the pus cell count was 2 - 5. A few days later I again had almost pure blood in my urine and the pus cells were 8 -12.
Went to the hospital and had an ultra sound of my bladder and kidneys. Left kidney somewhat dilated and bladder has some soft tissue which may be either blood clots, or recurrence of a tumor. That scares me.
I had the bloody urine for about 24 hours and then it stopped. After another 24 hours or so my urine is getting a deep orange color and I`m fearful the blood will reappear soon. I had hoped the hospital would find the cause of the bleeding but it didn`t happen.
The only thing abnormal I had done prior to reappearance of the bleeding was attempt to walk a lot to strengthen my lungs. I did that for 2 days prior to the bloody urine. Being diabetic, is it possible that the scraping of the tumor from the bladder wall is slow to heal because of the diabetes? Its about 10 weeks now.
Could the bleeding be from another part of the urinary tract? Why can`t the infection I have be pinpointed? Or how can it be pinpointed? Thank you.
You have a lot of very good questions. Blood in the urine could be from the prior surgery, or an infection or from somewhere else in the urinary system. Healing is sometimes slower in patients with diabetes. It sounds as though you really need to follow-up closely with a Urologist to evaluate you further and discuss these issues in more detail.
Lee E Ponsky, MD
Associate Professor of Urology
School of Medicine
Case Western Reserve University