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hematuria after proton therapy 4 years

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Posted 7/29/2019 10:49 AM (GMT 0)
All day yesterday I had frequent urination. My wife even mentioned that I seemed to be peeing a lot. I had no explanation for it. Right before bedtime and another trip to empty my bladder I passed a blood clot. No pain associated. I called my urologist at home and he said more than likely late hematuria following radiation. He said he sees it frequently. He said to make appointment for Tuesday and he'd check urine and maybe look into bladder. I am going into the hospital for surgery soon for complications following appendectomy and have had 2 CT scans and multiple urine tests in past week. Nothing abnormal was found on either. What do you think? Radiation after effects? Or worse?
Posted 7/29/2019 2:08 PM (GMT 0)
Happens post PT. Known side effect.

Get it checked out, likely it will clear on its own.

Rarely points to anything worse.
Posted 7/30/2019 4:56 PM (GMT 0)
Hematuria following prostate radiotherapy is a known toxicity that may adversely affect a patient’s quality of life.

Did you have SBRT? It's well understood that the risk of radiation-induced hematuria is dependent upon both the total radiation dose and the volume of the urethra/bladder neck in the high dose area. The concern is that the higher dose of radiation per fraction in SBRT creates an environment where post treatment hematuria would be more common than with other RT approaches. Men with prior TURP procedures were also prone to hematuria post-RT...did you have one?
Posted 7/30/2019 5:39 PM (GMT 0)
I had my urological exam today for the hematuria problem. My urine sample was clear; no blood. The urologist read my recent CT scans of the abdominal and chest taken 2 weeks ago for another problem. He said all were clear and normal. He then decided to do a cystoscopy to look at the uthera, bladder, and prostate. He showed me the screen as he was doing the examine. My first cystoscopy by the way. He said all were very clean and normal. The prostate looked good too he said but did have more after effects of radiation since it was the target. Nothing to indicate cause of bleeding. His differential diagnosis would suggest the prostate since a clot at the end of the urine stream usually comes from the bladder or prostate. The bladder and urethra were pristine so he ruled them out.

My radiation was Proton at UFPTI.
Posted 7/30/2019 5:54 PM (GMT 0)
oops, sorry, I previously missed your reference to proton therapy in the Subject line. Hopefully you won't have more of these...
Posted 7/30/2019 7:52 PM (GMT 0)
possible: radiation cystitis

It can come and go. Even after years. One of the long term RT SEs.

Also, as my doctor tells me, a little blood can look like a lot when it's in the toilet. Just a drop or two can seem like gallons. Be watchful, but not overly concerned. If it reoccurs, there are a few treatments. But just as likely this will never happen again.

Andrew
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