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Muneeb Ali
Muneeb Ali, Emergency Medicine
Category: Urology
Satisfied Customers: 7388
Experience:  MBBS,MD,ECFMG certified. Have dealt with urological emergencies in the ER on a regular basis
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I have ureter kidney stents for 15 months. I have metastized

Customer Question

I have ureter kidney stents for 15 months. I have metastized prostate cancer, taking degarilex hormone treatment. Everything has been stable, psa about 2 and testosterone nil. Last stent replacement was four months ago. Had gastro Sunday 5th August with violent vomiting and diarrhoea which cleared up next day. Two days later noticed blood in urine. Small amounts of urine, probably due to dehydration. Next day went to GP, only blood detectable was microscopic, no infection, no discomfort. Today noticed blood in urine with quite chunky clots. Still no discomfort or fever. Is it possible stent has dislodged due to violent vomiting. My urination has been as it was prior to gastro, frequent, smaller amounts during day, larger at night, good to reasonable flow. I am currently in remote location, four to five thousand kilometers from my urologist who I cannot contact until morning, in twelve hours time. Any advice. There is a small hospital nearby with limited facilities and certainly no urologist. Thanks
JA: Is the condition chronic, or acute?
Customer: not chronic, only this afternoon. Acute? I have only noticed this amount of blood and any clotting of blood in urine only after having stents inserted the first time, 15 months ago
JA: Anything else in your medical history you think the doctor should know?
Customer: I have had radiotherapy 12 to 15 months ago for prostate cancer. The caner spread to bones and has appeared to have diminished marginally since hormone treatment, commenced 15 months when kidneys failed due to ureter blockage. All has been fine
Submitted: 2 months ago.
Category: Urology
Expert:  Muneeb Ali replied 2 months ago.

Hi,

Welcome to JA and thanks for this question. Im sorry to hear about your symptoms. Actually while the ureter should not be dislodged because of vomiting, it can sometimes move inside the ureter and cause irritation of the lining which can lead to mild bleeding of this sort. Usually mild bleeding of this sort should settle down on its own however sometimes it can persist and if it persists for more than 12-24 hours then it should be re evaluated with the help of an xray or even a CT scan to check the location of the stent. Secondly, it can sometimes also cause pain in the abdomen because of the stent moving inside it.

Now my recommendation is to wait and watch the bleeding for now, drink more water than usual which should help in clearing up the urine and if necessary use OTC anti inflammatory medications like ibuprofen if you have any pain in the region. But for now you dont need to rush to the hospital ONLY if the bleeding worsens over the next few hours and the blood is continuously being poured out or the amount iof the clots are increasing then you should head to teh local hospital where they can start medications to control the bleeding such as tranxenamic acid. Another reason to head to the ER would be inability pass urine at all. Otherwise you can wait another 12 hours, just keep a close eye on the symptoms.

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