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Why is it done?

Primary management of:

  • Continuous or intermittent bleeding from bladder vessels
  • More prominent after radiation therapy with neo-vascularisation
  • Induced or aggravated by blood thinning and anti-platelet therapy


Risk factors:

  • Anti-coagulation therapy: Warfarin, Xaralto etc
  • Anti-platelet therapy
  • Radiation to bladder prostate or bowel
  • These need to be stopped prior to the procedure


How is it done?

  • This is done under General anaesthesia.
  • A cystoscopy is performed by placing a camera in the urethra with the help of a lubricant gel and saline irrigation.
  • The bladder is then distended with saline.
  • A resectoscope is then placed.
  • I use Bi-polar resection, thus using Saline as irrigation.
  • The vessels are cauterized and sealed
  • A 3-way catheter is placed with continuous saline irrigation until your urine is clear
  • Antibiotics may be given to prevent infection.




  • You may have a 22 –24 French (thick) 3-way urethral catheter placed through your urethra.
  • It does have a channel for placement of constant saline irrigation and another for the drainage of the blood-stained urine.
  • The Continuous bladder irrigation will continue until your urine is clear approximately 24-48hrs.
  • This can also be remedied by drinking plenty of fluids until it clears.
  • As soon as the colour of your urine is satisfactory, your catheter will be removed.


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Copyright 2019 Dr Jo Schoeman