Patient's question:
Wang Keda, 75 years old. Over ten years ago, he underwent transurethral resection of the prostate (TURP) due to benign prostatic hyperplasia. Nine years ago, he was diagnosed with prostate cancer and received hormone therapy followed by X-ray radiation. He had been undergoing follow-up every three months, which was later changed to annual check-ups, with results consistently normal. In July 2012, after experiencing atrial fibrillation, he started taking anticoagulant medication. In mid-August, he developed hematuria, which stopped after stopping the medication for three days. The doctor advised him to continue taking the anticoagulant, but the hematuria returned a few days later. When the anticoagulant was stopped again, the hematuria could not be controlled. Ultrasound, X-rays, cystoscopy, CT scans, and blood tests were performed, but no abnormalities in the urinary system were found. A specialist analyzed that it was due to a ruptured vessel in the prostate. On September 20, he underwent surgery (cystoscopy, bilateral retrograde pyelography, biopsy, and electrocautery treatment for the prostatic fossa). The treatment report stated: "There is a defect in the left prostate resection site, with mild growth of adenoma-like tissue; it is a sign of radiation cystitis. No stones, tumors, or mucosal defects were observed. During bilateral retrograde pyelography, no filling defects or significant hydronephrosis were seen. A bladder biopsy was performed in the inflamed area of X1, with normal results. There were several bleeding points in the prostatic fossa, which were treated with Bugbee electrocautery." After two weeks of observation, the hematuria did not stop. All treatments were conducted in Boston. On October 4, he returned to Beijing. On October 5, he visited the Navy General Hospital and started taking Yunnan Baiyao, which slightly reduced the hematuria. Two weeks later, he stopped taking the medicine. On October 9, he visited the Nephrology Department at Xiyuan Traditional Chinese Medicine Hospital and tried taking Chinese medicine for a week, but it was ineffective. She advised him to see a urologist. On October 16, he visited the head of urology at 307 Hospital. He said rest was the main treatment, and immediate surgical treatment was not necessary. On October 19, he visited the elderly TCM doctor Jiang (Chief Physician of TCM at 301 Hospital). Recently, he had low blood pressure and headaches. After taking five doses of herbal medicine, urination became smoother, but the hematuria did not significantly improve. On October 26, his follow-up visit showed that the amount of amber powder was increased to 1.5 grams. After seven doses of medicine, both blood clots and blood volume decreased. After about ten doses, there was no visible blood color, and the urine was very pale. Due to the high dosage, one dose was split into two days of consumption. On November 5, his follow-up visit showed that the hematuria had stopped for several days. The prescription was adjusted to improve blood circulation (saffron, Fritillaria cirrhosa). The hematuria stopped after several weeks. Today, he is about to return to the United States. Thank you for the face-to-face consultation with Director Chen on October 16! Wang KedaDoctor's answer:
The condition you described may be caused by prostatitis. Treatment primarily involves oral antibiotics, with a course of 4 to 6 weeks. Selective sensitive drugs should be chosen, and α-receptor blockers can be used to improve urinary symptoms and pain. Medications such as herbal preparations, non-steroidal anti-inflammatory analgesics, and M-receptor blockers may also be used. Avoid spicy foods, alcohol, tea, coffee, and other stimulating foods during daily life.