Pune, Feb 26: Doctors at Manipal Hospital Kharadi successfully treated a 70-year-old gentleman who developed life-threatening urinary bleeding just three days after undergoing cardiac angioplasty. The patient had been evaluated for ECG changes during a routine cardiology check-up and underwent a successful angioplasty.
The patient was started on dual antiplatelet therapy, but within three days, he presented to the Urology OPD with passage of blood clots in urine. Further evaluation revealed nearly 300 ml of clots in the urinary bladder along with a massively enlarged prostate measuring approximately 250 cc. The antiplatelet therapy had triggered active bleeding from the prostate, making the situation critical.
An emergency clot evacuation and fulguration of bleeding vessels were performed, following which the patient was shifted to the ICU for close monitoring. Despite initial intervention, he developed recurrent clot retention and continued bleeding. Given the high risk of stopping or continuing antiplatelet therapy, a multidisciplinary team comprising Cardiology, Urology, Interventional Radiology, and Critical Care carefully evaluated the case.
Considering the complexity, a minimally invasive prostate artery angioembolization was performed by Dr. Santosh Patil, which successfully controlled the bleeding. The patient was discharged with a urinary catheter after stabilization. Six months later, once it was safe to discontinue antiplatelet therapy, he underwent definitive treatment with Laser Enucleation of the Prostate for his enlarged prostate.
Speaking about the case, Dr. Ankit Sharma, Consultant – Urology, Manipal Hospital Kharadi, Pune, said,
In elderly patients who have recently undergone cardiac procedures, managing bleeding complications becomes particularly challenging due to the need for life-saving blood thinners. In this case, the patient presented with acute haematuria and clot retention soon after angioplasty. Evaluation revealed a significantly enlarged prostate of nearly 250 cc with active bleeding triggered by dual antiplatelet therapy.”
Further he added,
“Given the mandatory continuation of blood thinners, the massive prostate size, and recurrent clot formation, this was an extremely high-risk scenario where conventional surgery carried significant danger. Despite these complexities, the team proceeded with minimally invasive interventions — including emergency clot evacuation, prostate artery embolization, and later laser enucleation of the prostate once it was safe. The bleeding was completely controlled, and the patient’s quality of life improved significantly during recovery.”
The patient has now fully recovered following the laser surgery and was discharged in stable condition. Doctors emphasize that blood in urine should never be ignored, especially in elderly patients or those on blood thinners. The case highlights Manipal Hospital Kharadi’s advanced technology, minimally invasive expertise, and strong multidisciplinary approach in managing complex, high-risk conditions with successful outcomes.
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