What Does Presence Of Blood Clots After Having Urostomy Placed Suggest?

Posted on Tue, 21 Apr 2015

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Tue, 21 Apr 2015 Answered on

Mon, 11 May 2015 Last reviewed on

Question : My friend's dad just had a urostomy placed about 3 weeks ago....was just diagnosed with cancer. His urostomy is constantly having blood clots....she's with her dad in Russia and she was told it will just get worsen. It's supposed to decay more and more from the outside?? And there's a foul odor now.....the family decided no heroic measures. The hospital there is suggesting blood transfusion. What's the standard of care here in the U.S.?
She's so devastated and wondering the ethical thing to do with her father.

Answered by Dr. Indranil Ghosh (1 hour later)

Brief Answer:
Probably it is a palliative scenario

Detailed Answer:
Hi

Thanks for your query.

I understand your concerns. We need a bit more detail to form an opinion in his case. I guess it is an advanced cancer in which the cancer has spread so much that the urine system got blocked and there is no scope of chemotherapy because of poor general health of the patient. Hence, the urostomy has been done to vent the urine out. But as the disease is still there, the bleeding and foul odour continues. Please correct me if I am wrong and don't hesitate to write back with the correct scenario.

If I am correct in guessing the scenario, then best supportive care is appropriate, including hospice care. Blood transfusion is considered a part of palliation as per international consensus and it can be done. But the most important part is try and mainatin quality of life and let him pass the last few days with dignity.

Hope this helps.
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar