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What Causes Bleeding From Urethra During Defecation?
Posted on
Tue, 15 Sep 2015
Tue, 15 Sep 2015
Answered on
Tue, 6 Oct 2015
Last reviewed on
Question : Often when I defescate there is a red stream in the front of the toilet bowl which suggests blood in my urine. This is any when I am deficating, frequently, but not always. I do have a large prostate but stable and consistent PSA of 1.8. I am in my late 70's.
Brief Answer:
Urine cytology, culture, cytoscopy and urologist's opinion.
Detailed Answer:
Hi and thanks for the query,
The very good thing first of all is that your PSA levels are ok. It might also be reassuring especially is the symptoms for prostate enlargement are stable or evolving favorable all this while.
It is possible that the blood could be coming from the urinary tract under under special circumstances. The bladder is located just in front of the rectum. A problem with the bladder, like an infection could bleed when stool from the rectum exerts pressure on it, especially if it is inflamed. Doing a urine sediment test, and microscopy, first to confirm that the redness is actually blood (when red blood cells shall be seen in large numbers) is of utmost importance.
I strongly suggest a test to appreciate the integrity of the bladder in case this is persisting, especially after doing the cytology and microscopy. With a proper review from your urologist, a cytoscopy (test to visualize the bladder) could be done.
Do you experience any back pain, pain on urination or lower abdominal pains or any fevers? If not, there should no much reason to be bothered.
However, the opinion of the urologist to examine you again, test for the quality and content of urine to ascertain blood in urine and a cytscopy if needed could be very useful.
Thanks and kind regards as I wish you the best of health.
Dr Bain
Urine cytology, culture, cytoscopy and urologist's opinion.
Detailed Answer:
Hi and thanks for the query,
The very good thing first of all is that your PSA levels are ok. It might also be reassuring especially is the symptoms for prostate enlargement are stable or evolving favorable all this while.
It is possible that the blood could be coming from the urinary tract under under special circumstances. The bladder is located just in front of the rectum. A problem with the bladder, like an infection could bleed when stool from the rectum exerts pressure on it, especially if it is inflamed. Doing a urine sediment test, and microscopy, first to confirm that the redness is actually blood (when red blood cells shall be seen in large numbers) is of utmost importance.
I strongly suggest a test to appreciate the integrity of the bladder in case this is persisting, especially after doing the cytology and microscopy. With a proper review from your urologist, a cytoscopy (test to visualize the bladder) could be done.
Do you experience any back pain, pain on urination or lower abdominal pains or any fevers? If not, there should no much reason to be bothered.
However, the opinion of the urologist to examine you again, test for the quality and content of urine to ascertain blood in urine and a cytscopy if needed could be very useful.
Thanks and kind regards as I wish you the best of health.
Dr Bain
Above answer was peer-reviewed by :
Dr. Neel Kudchadkar
Thank you for your reply
Perhaps relevant is a condition of a few years of blood in my semen (usually brown coffee colored semen, but occasionally bright red.) The urologist was not concerned and explained that microscopic blood vessels in the prostate can break upon ejaculation causing blood in the semen. Is it possible that the blood when defecating could be coming from the prostate?
No pain on urination but occasional mild pain from diverticulosis. No fever.
Perhaps relevant is a condition of a few years of blood in my semen (usually brown coffee colored semen, but occasionally bright red.) The urologist was not concerned and explained that microscopic blood vessels in the prostate can break upon ejaculation causing blood in the semen. Is it possible that the blood when defecating could be coming from the prostate?
No pain on urination but occasional mild pain from diverticulosis. No fever.
Brief Answer:
evaluate bladder, see urologist, unlikely to come from bladder
Detailed Answer:
Hi and thanks for the update,
It is difficult for me to think the blood could come from the prostate. The prostate properly surrounded by solid tissues and the pressure from the rectum or colon cannot be felt directly or significantly at the level of the prostate.
Your answers still make me think the bladder be properly checked , a proper urine cytology still done and you get again the opinion of the urologist. It is very much needed in this case since you its not seen in semen as was the case, but during defeacation. The possible explanation might be different in my opinion.
Thanks and kind regards as i wish you the best of health.
Dr Bain
evaluate bladder, see urologist, unlikely to come from bladder
Detailed Answer:
Hi and thanks for the update,
It is difficult for me to think the blood could come from the prostate. The prostate properly surrounded by solid tissues and the pressure from the rectum or colon cannot be felt directly or significantly at the level of the prostate.
Your answers still make me think the bladder be properly checked , a proper urine cytology still done and you get again the opinion of the urologist. It is very much needed in this case since you its not seen in semen as was the case, but during defeacation. The possible explanation might be different in my opinion.
Thanks and kind regards as i wish you the best of health.
Dr Bain
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Above answer was peer-reviewed by :
Dr. Neel Kudchadkar
Answered by
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