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Urology/Long term prostate bleeding

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Issue:  Long term prostate bleeding following green light laser surgery & subsequent TURP
Background:  GL laser prostate reduction 12/09, 3 incidents of excessive prostate bleeding blocking urination culminating with a TURP 11/12. Finastride prescribed but caused tactical pain and was discontinued 6/13.  I take aspirin for heart issues.  Bleeding since TURP has been periodic and most activated by walking/exercise.  Usually I discontinue the aspirin and walking/exercise when blood shows up in blood & rest several days; this stops the blood.  Since the beginning of the year 2014 I have had 11 days of bleeding & the last 4 days it has been heavy & does not appear to be subsiding by using the previously successful method.  My PSAs are very low.  My urologist has indicated that bleeding is a way of life & get used to it & says he will do another TURP if my urinary tract becomes blocked with blood again.  Should I seed another opinion from a second urologist?  Looking for a solution.

Answer
Gary:

Laser therapy is usually very effective in controlling bleeding.  Obviously the aspirin is contributing.  Finasteride would be helpful if you could take it. In some cases, a low dose of radiation can help with persistent prostatic bleeding.  Another option is prostatic artery embolization but these are usually done only in severe bleeding refractory to all other options.

At this point, a second opinion would be reasonable.

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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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