Zoladex misfire???

If you peed the implant out, then it went into your bladder, which I suspect would be possible if the needle went in perpendicular. It's how suprapubic catheters are inserted into the bladder.

Bleeding could be a red herring. There are some significant veins through the fat layer where the implant is meant to go, and there's always a chance of hitting one. Usually it causes the implant shell (syringe, but it's not actually a syringe) to immediately fill with blood. If that happens, they are supposed to withdraw without operating the plunger, discard, and get a new implant.

The question is what you do now about the dose, and that depends how certain the implant was lost. Did you keep it?

Also, what you do about the incident at the GP. If it was done incorrectly, that needs reporting as a medical incident. It could be that lots of patients have been done incorrectly buy that healthcare worker.

If I was asked how to resolve uncertainty of a Zoladex implant being done correctly or not, I would say you need to have a 4-weekly blood tests of Testosterone, LH (Leutenising Hormone), possibly FSH, and might as well add PSA too, starting now, and continuing to the next Zoladex injection. If Testosterone, LH, FSH start rising, this would suggest the Zoladex implant was lost.

Another option would be to put you on bicalutamide for the duration of this Zoladex implant, extending 2 weeks past the next Zoladex implant. That should be OK whether or not the Zoladex implant is active, and covers for ant-flare on next implant if it wasn't active.

Haematomas sometimes just happen with injections but that's different to inserting the injection into a muscle layer rather than sub-cutaneously. A haematoma, like a bruise, is the result of broken blood vessels just below the skin. It will hurt in the same way a bruise hurts and can continue to hurt for a day or more. An injection that gives you a haematoma might hurt a little more than usual but is quite bearable.

Inserting the {large} Zoladex needle into the fat that lies under your skin doesn't hurt much but once that needle starts to go into muscle, it really does hurt, so I doubt that your injection went into, or through the muscle layer. With a capsule in the muscle layer you can feel a specific local irritation at the exact site for a few days, unlike the usual shots which can't be felt after a few hours. In the case that a capsule went into the body cavity I was advised it would be absorbed but the speed of uptake would be unknown. In some rare cases the needle can penetrate an intestine near the stomach wall or even a major blood vessel if they go in near the belly button.

From your description I'm doubtful that your last injection went into or through the muscle layer and there is no way a blood clot from the site of the injection could get into your urinary tract because of the way these plumbing systems work.

Blood in the urine is not necessarily of huge significance but certainly if it happens again or if you've got any other symptoms, you should have a chat with your GP

Jules

I'm going to partially agree/disagree with both previous comments.

The first thing to say is the medication has instructions on the packaging of how it is to be used and when and what doses to be given. That is the only correct advice you can have. Very much what Lyn has said. Because there is a reasonable chance something went wrong this needs investigation by a medic.

Everything from here on is my speculation from a layman.

My own experience of coming off HT was that it took 9 months for my testosterone to return. So I don't think shifting a three month dose by a week or two would make any difference. Because of this I don't think a testosterone or PSA test would show any change within at least a month of this misfire, and having a test may falsely reassure you.

I moved some of my doses from week 12 to week 11 to time with holidays. I don't think I ever extended a dose to week 13 though.

I don't know how they can investigate this. Looking for a pellet under your skin is probably impossible. I couldn't feel any of my pellets. As I have said testosterone check would probably not show anything, but if you had a testosterone check every week from now it may pick up a trend. Possibly they should just inject another pellet. I don't know if a double dose of zoladex is dangerous, I doubt it.

Thank Microcolei for for you response, I believe you when you say ''it's quite possible for the Z needle to go right through.'' more than I believe the person I spoke to this morning. Its quite frightening really, but to be truthful, I expected this answer. This will remain a mystery for me because her 3rd point is valid. I have never seen blood on the rim of the toilet before and the timing of this discovery coincided with the unusual amount of blood spilled during the shot 7 days before.  But coincidences are often that, coincidences. J, you pointed to fear in regards to how SERIOUS these injections are. This cannot be over stated in these days of shortages within our care systems.

Respect to Andy for taking matters into his own hands.  For me, I am not that brave but from now on, I will watch them like a hawk during Zolidex injection process. 

Thank you all for your responses, I know that I missed responding to some.

To the people that follow,

don't fear biopsies and watch every part of what is going on when it comes to Zolidex injections!

Thank you all!