A patient from Guam visited us with unexplained hematuria (blood in urine).
Despite prior evaluations, the cause had not been identified.
We performed a cystoscopy on the same day.
What We Found
The examination revealed:
- Severely enlarged prostate (benign prostatic hyperplasia: BPH)
- Abnormally dilated and fragile blood vessels (likely the source of bleeding)
- Bladder diverticulum
- Voiding dysfunction
Hematuria Is Not Always Cancer or Stones
When patients notice blood in urine, they often worry about:
- Bladder cancer
- Kidney cancer
- Urinary stones
These are important conditions to rule out. However, hematuria can also be caused by:
👉 Enlarged prostate with vascular changes
In BPH, increased blood flow and fragile vessels in the prostate can lead to bleeding, especially when combined with urinary obstruction.
Treatment: HoLEP
After explaining the diagnosis and treatment options, the patient underwent:
HoLEP (Holmium Laser Enucleation of the Prostate)
at Kameda Medical Center.
This procedure:
- Removes the enlarged prostate tissue completely
- Simultaneously controls the bleeding source
- Improves urinary flow significantly
Outcome
The patient had an excellent recovery:
✔ Hematuria completely resolved
✔ Urinary symptoms dramatically improved
We later received a message from our international team that the patient was very satisfied with the outcome.
Take-Home Message
Hematuria is a visible warning sign, but its causes vary.
👉 Not only cancer or stones
👉 The prostate can also be the source
Accurate diagnosis is essential.
If you have been told that the cause of hematuria is unclear,
a specialized urological evaluation may reveal the answer.
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