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Blood/Blood clots in urine 5 weeks after RP

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Posted 5/2/2023 2:43 AM (GMT 0)
My husband (51 years old) had a Robotic Prostatectomy about 5 weeks ago. Pathology showed Pt3a, bladder neck invasion, perineural invasion, non-focal EPE, negative margins, no positive lymph nodes. Last week at 4 weeks post op he began having on and off blood and blood clots in his urine. Previously, he had not had any blood in urine since about 3 days after surgery. Dr advised to stop pelvic floor exercises for a week. Blood/blood clots have continued sporadically. Largest clots have been dime sized. Anyone else experience anything similar after RP? Wondering what could be causing this.
Posted 5/2/2023 11:03 AM (GMT 0)
I recall having odd things about this point. Among other things, I recall passing little black bits of sutures. Healing is still going on. At about 4 weeks, he's probably feeling pretty good, and with spring coming, the temptation is to start doing more physical stuff. Whether it is kegals, or walking or biking, or working in the yard, all of those things can strain the areas that are still healing from the surgery.

If he has recovered sexual function, that is another spot where overdoing things can be a problem.

Best suggestion: drink lots of water, keep track of physical activity and when the clots appear. Unless he's on blood thinners, chances are things will clear up in a short while.
Posted 5/2/2023 12:33 PM (GMT 0)
I agree with halbert. There are only two obvious places where blood might come from: the urethra where it was stitched back together or the bladder. Physical activity seems to be a likely cause but he was a month after surgery when it started so stay in touch with doctor if it continues.

Let your husband know that if he does not settle down and stop bleeding, the urologist will go looking for causes with his equipment which may prompt him to heal faster. That along with hernia concerns motivated me to take it real easy for a month post-op.
Posted 5/2/2023 4:58 PM (GMT 0)
Thanks so much for the replies. Yes, at times it does seemed triggered by activity. He has definitely struggled taking it easy because he feels (relatively) fine. But it has also happened when he has been resting (in fact, he had the largest blood clot pass after a couple of days of resting over the weekend). I will take your advice Mumbo, as he most certainly doesn’t want that!!
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