Hello and welcome to HCM. Thank you for your query. The foremost thing we will have to do is to visualize the urethra, bladder and other structures of the urinary tract. While this could be a result of the surgery which took place 7 years ago, this is unlikely, but will have to be ruled out. The two investigations I suggest are a flexible cystoscopy and an ultrasound of the prostate. Please visit your doctor at the earliest and get these investigations done. We should not waste much time as your brother is losing blood. Clotted blood is a sign of a stagnation/collection of blood for a while, after which it is being passed. This means it could be somewhere below or around the bladder. It is crucial for us to find the source and stop the bleeding. I hope my explanation is clear. An exploratory flexible cystoscopy will be more helpful than a rigid cystoscopy in such cases. An ultrasound before the cystoscopy might give us information on what to expect from the cystoscopy. The obstruction in passing of urine is another problem, which is usually dealt with either a urethral or supra-pubic catheter, but it would be better to first conduct these investigations and then go ahead with catheterization (if required). I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications. I would gladly help you. Best wishes.