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Questions posted in the
The Urology Forum have been answered by urologists from Henry Ford Health System and by Dr. Kevin Pho.
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Subject: Re: Blood in Urine During my physical exam, the doctor mentioned that blood was found in my urine (dip stick method). I now have an appointment with an Urologist. I'm 48 years old, don't smoke, run 45 miles per week. What can cause this problem? Is cancer a high probability or could it be exercise induced? I am quite concerned. Thanks.
_____ Dear Larry, Hematuria is the medical term for your condition. It is important to have a microscopic cell count done to determine if this amount of hematuria needs to have a full work-up or not. Above 3 RBC/HPF is suggestive of significant hematuria that needs work-up. A full work -up consists of a history and physical to direct the studies ,an IVP, a cystoscopy which should be done by a urologist, and a cytology looking for cancerous cells in the urine. About 30% of patients at our institution have some pathology causing there hematuria. Considering the lack symptoms and your history of exercise, you probably will not have any pathology, but if you have significant hematuria, you should have a full work-up. Other possibilities include a urinary stone, some stones are made of Uric acid and are not seen on IVP. You could also have an infection, although without symptoms this is unlikely. Blood in the urine can be caused by a simple infection of the bladder, which could be found on the Urine analysis(UA A third possible diagnosis would be bladder cancer. Some times bladder cancer presents with blood in the urine and irritative symptoms. Most patients usually do not have symptoms, but it is possible depending on the size and location of the tumor. This is why we perform cystoscopy, to rule out any suspicious lesions in the bladder. The cystoscopy also allows the urologist to examine the anatomy of the bladder and position of the ureteral openings in the bladder. Our last diagnosis would be idiopathic, simply meaning, we dont know. Patients that exercise or have bleeding disorders can often have blood in their urine without a good explanation. These patients get the same work-up listed above to ensure they dont have a treatable condition, you may fit into this later category. I would suggest you have a repeat UA and if the microscopic analysis is high, RBC>3/HPF, go and see a urologist a full evaluation. This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568). Sincerely,
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