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Urology/Internal healing After TURP

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Question
I had a button plasma TURP 16 months ago. Ten days after the surgery, urine was completely clear of blood until 6 weeks ago. In the past 6 weeks I've had several days of blood and debris looking like tea leaves in my urine. These events are triggered whenever I lift something heavy. My question is: After the surgery does the body heal itself so that the urethra is like it was before the surgery or is there merely a protective layer formed inside the prostate that can be compromised by certain conditions such as a combination of heavy lifting and daily dose of 20 mg of rivaroxaban(Xarelto) plus alcohol. Urine returns to normal after a day or two of rest and no alcohol. I normally limit myself to two glasses of wine daily but occasionlly have three or a beer as well. Could the anticoagulant plus the alcohol plus the heavy lifting cause a tear in the protective lining? I'm scheduled to see my urologist in a week and he wants me to have a urogram and cystoscopy. I'm wondering if these tests are really necessary.

Answer
Jay:

The body does heal but not the way it was prior to surgery or there would be no point to the surgery.  After TURP type surgeries, healing will often take time, but 16 months is a little too long for more healing.  You should contact your urologist to check this out.  Xaralto is an anticoagulant and will increase bleeding so this coudl be the immediate cuase, but it needs to be checked by your urologist.  A urogram and a cystoscopy are appropriate and necessary.  Just because it could be something simple doesn't mean you can or should ignore the potentially serious problems so your urologist is being cautious, appropriately.

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Stephen W. Leslie, MD

Expertise

Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.

Experience

Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

Organizations
American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Publications
Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Education/Credentials
Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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