Is hematuria (blood in the urine) or bleeding in the penis a normal complication after extracorporeal shock wave lithotripsy (ESWL)?

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Last updated: April 8, 2025View editorial policy

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From the Guidelines

Bleeding from the penis after lithotripsy is generally considered a normal and expected complication, typically manifesting as hematuria that may last for several days to a week following the procedure. This is because lithotripsy involves the use of shock waves to break up stones, which can cause minor trauma to the urinary tract tissues 1. The study from 2007 notes that complications from shock-wave lithotripsy (SWL) for ureteral stones are infrequent 1. Key points to consider include:

  • The bleeding is usually mild and appears as pink or red-tinged urine.
  • Increasing fluid intake to 2-3 liters per day can help flush out the urinary system and promote healing.
  • It is essential to monitor the bleeding and seek medical attention if it becomes heavy, is accompanied by clots, severe pain, fever above 101°F, inability to urinate, or persists beyond a week, as these could be signs of complications such as infection or blockage from stone fragments 1. The 2007 guideline for the management of ureteral calculi provides insight into the management and complications of lithotripsy but does not specifically address the issue of bleeding from the penis 1. However, given the nature of the procedure and its potential to cause minor trauma to the urinary tract, some degree of bleeding is anticipated.

From the Research

Bleeding in Penis after Lithotripsy

  • There is no direct evidence in the provided studies that specifically addresses bleeding in the penis after lithotripsy.
  • However, the studies do discuss potential complications of lithotripsy, such as hemorrhage and damage to surrounding tissues 2, 3.
  • One study reports a case of severe perinephric hemorrhage after shockwave lithotripsy, which required nephrectomy 2.
  • Another study describes a case of massive retroperitoneal hemorrhage after extracorporeal shock wave lithotripsy (ESWL), which resulted in the patient's death 3.
  • These cases suggest that lithotripsy can cause significant bleeding complications, although they do not specifically mention bleeding in the penis.
  • It is essential to note that the provided studies focus on different aspects of lithotripsy and its complications, and there is no direct evidence to confirm whether bleeding in the penis is a normal or common complication of lithotripsy 4, 5, 6.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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