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Blood in urine post biopsy

Posted 22 Jul 2019 at 20:29

Apologies if this is posted in wrong forum/topic

Would welcome thoughts/guidance re blood in urine, post biopsy

I have previously undergone 2 "standard" TRUS biopsies and suffered no ill-effects/problems (small "bloody" discolouration of urine for 2-3 days as well as blood in ejaculate for 2-3 times).

However have recently had a fusion biopsy and with "training" registrar looking on - this naturally; with the training aspect took quite a bit longer and more samples taken - some needed another attempt ie not enough tissue in sample hence re-try 

So now 5 days later urine is still a bit discoloured - more the colour of a light rose wine!!! 

How long is it in peoples experience that the urine takes to return to "normal"

Not feeling un-well or in any pain, plus no sign of blood in faeces

Thanks - grateful for your thoughts


Posted 22 Jul 2019 at 23:36

I didn't have much in my urine. It only ever showed in the first few cc's when starting to pee, presumably as the first bit of urine washes it out of the urethra through the prostate. If all your urine stream is coloured, that might suggest blood is going into the bladder and mixing with the urine, which I think is not unexpected. If you are on tamsulosin and you are ejaculating, you will likely have some retrograde ejaculation into the bladder (a side effect of tamsulosin), and that could carry blood into the bladder.

I had blood in my semen for 3 weeks, with daily ejaculating. I recall the leaflet for the procedure said that could happen for up to 6 weeks (maybe if you don't flush it out so often - my urologist said don't hold back ejaculating). I can't remember how long it suggested for blood in urine, but it was less - maybe 3 weeks.

Posted 23 Jul 2019 at 07:08
It can take a couple of weeks for all traces of blood to disappear from urine. Nothing to be concerned about.

Best wishes,


Posted 27 Jul 2019 at 22:35

Andy, Chris

Thanks for your comments, I am a little more relaxed after reading your replies.





Posted 09 Oct 2019 at 02:55


Beware of the biopsy. I had a TRUS biopsy with 12 cores taken here in the US. The procedure was not great but not as bad as one might think. About 4 samples from the Apex hurt during the procedure. That night just sore. Yes blood in my urine, stool and ejaculate. That is where routine stopped.


The day after biopsy I had burning urination, pain at the base of my penis and an impossible time trying to pee. Doc thought I may have an infection and gave a week of Sulfa antibiotic. It cleared most of this up but still had some blood in my urine and soreness in my pelvis. It hurt to ejaculate like squeezing a thorn down there and the ejaculate was all just red blood.


I am 14 days after biopsy now. I have pain in my pelvis, and some blood in my urine. It still hurts to ejaculate and the ejaculate is all still fresh red blood. I am on a new antibiotic for 21 days Doxycycline. No relief in sight. Doc says it's not uncommon to have these side effects for a month.


I know your thinking I'm old or sick and have these problems. I am 45, in great health and don't take any medications regularly. I'm in great shape except for this. The day before biopsy I had no pain, no urinary problems and completed my Crossfit work out. As of now I can't exercise without pain.


My biopsy was for a PSA of 5.1 with free PSA of 25%. My results were all benign. I regret ever having the biopsy.


Posted 09 Oct 2019 at 08:02
Unfortunately a biopsy is the only way to know for certain whether or not you have cancer, Toby. In a small percentage of cases there can be complications, but this is not normal. Generally, a couple of day of soreness and blood in the urine and semen is as far as it goes.

Happy to hear that your biopsy came back "all clear", but with a PSA of 5 at your young age it's completely understandable that you had the procedure.

Best wishes,


Posted 09 Oct 2019 at 11:17

TRUS is being phased out in the UK, and a transperineal version of it is replacing it (not the template biopsy).

This is because of the infection risk of piercing the rectum - around 3% of TRUS procedures result in infections, and this figure has been rising due to increasing antibiotic resistance, and some of these require hospital admission and can become full sepsis.

PCUK were quite key in jointly developing the new procedure with one of the hospitals (I forget which one), the key aspect of which was developing a local anesthetic procedure for the perineum so that the procedure can be performed in an outpatient setting (versus the transperineal template biopsy which was traditionally a theatre procedure under GA, but is also being tried as an outpatient procedure in some places now).

Posted 11 Mar 2023 at 22:14

Hi All, 

I had a trans perennial biopsy 2 weeks ago and experienced the same bright red blood in urine for about 3 days. It then stopped and I was feeling well albeit a little sore.

A few days later I had my first ejaculation - the same bloody horror show recorded by others on this forum. After that, blood started to appear again my urine but now a rusty brown as forecast.

After this first ejaculation my lower back ached for 2 days and urinating was slightly uncomfortable. I was worried that I’d attempted normality too soon.

Things then stabilised over the following days and blood disappeared from my urine again. Feeling quite chipper I tried another ejaculation a week later. Same result with lower back ache etc except that now my semen was brown. 

Since then I’ve been urinating more at night always with a rusty blood starter. Last night I leaked some small patches of blood on the bedding. Had a few other small blood discharges (possibly with semen?) during the day.

Feeling nervous about further ejaculations as I seem to take a step backwards for some days afterwards and fret about causing damage to myself.

I’m trying to work out if this experience is just a standard side effect or something to be concerned about.

Man up and carry on ejaculating or abstain and hope things settle back down again?

Many thanks for any feedback.



Posted 12 Mar 2023 at 00:36

The more you ejaculate, the sooner the old blood will be cleared from your system. Not sure the ache is common; it may just be because your prostate is a bit bruised and battered but if it continues, seek advice from your GP in case you have acquired an infection

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

Posted 12 Mar 2023 at 08:29

Afterwards, I asked the consultant urologist who did the biopsy how long I should wait before ejaculating, and he said "oh, don't wait".

I didn't get any pain ejaculating, but it took about 3 weeks of doing it daily to clear it out.

I had a second biopsy, and I had been on hormone therapy a while at that point, so there was almost no ejaculate and I didn't manage get the blood out. I know this because on a subsequent MRI, there's a bright white blob in my prostate. I said to the radiologist that I didn't think prostate cancer showed up that clearly. He said that's not prostate cancer, that's where you've bled and there was too much for the body to absorb it and clear up. It's broken down releasing the iron from the hemoglobin, and being magnetic, the iron shows up brightly on MRI scans. Having read more on MRI scans since, this iron also creates artifacts on MRI scans and prevents good high resolution scans of the area. This may have been why my urologist said "oh, don't wait".

Posted 12 Mar 2023 at 11:24

Many thanks for the feedback.

Looks like I may face another biopsy after getting 5/5 max MRI score for a high probability of cancer then a negative biopsy result (phone call from hospital on Friday telling me I was clear, having cancelled my first face to face meeting with the consultant I’ve never met, as they considered it no longer necessary)

They said the MRI analysis that they’d sub contracted to a private hospital was questionable as they had a history of dodgy results. Why send me there then!

I’ve been offered a further blood test, MRI scan and second biopsy - it’s my call apparently.

So a crystal vague test overall.

Disappointing to have yet more uncertainty

Edited by member 12 Mar 2023 at 11:25  | Reason: Not specified

Posted 12 Mar 2023 at 11:54

Contracting the MRI analysis to a useless hospital wasn't a good idea. So I think it is "return to start, do not pass GO, do not collect £200 (though I'm sure some private health company did)".

A new blood test is definitely a good idea. Maybe the original MRI images can be reexamined by someone competent, if not new scan is probably required.

If the new MRI detected a different region to target for biopsy then it may be worth it. If the new MRI results suggest the same region for the biopsy, I'm not sure I would have that.

I probably would have at least annual PSA tests and if PSA kept rising, investigate further. If PSA didn't rise I would put fears of cancer behind me, for several years. 


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