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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.
Question Title: Statistical chances of urinary tract cancerForum: The Urology Forum
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2 months ago I had a UTI, (WBC's, Bacteria, RBC's - culture positive). I was asked to come back for a followup after completion of antibiotic. I continue to show 1-5 RBC's in urine no other anomolies and culture negative. I am seeing a urologist for the standard workup. I am quite concerned as my mother died age 80, 1 year ago of renal cancer (transitional cell carcinoma). I am 40/female/smoke - statistically, what are the odds of me getting the bad news that I have cancer? what else could be causing this besides kidney stones? can forceful sexual intercourse cause a traumatic disturbance to the kidney causing the leaking of RBC's? could this just be residual RBC's left over from my prior UTI? Thanks for your response.
Dear Liz, 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. 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. Considering your previous UTI, you may not have any pathology, but if you have ongoing significant hematuria, you should still have a full work-up. Other possibilities include a urinary stone, which you mentioned. Some stones are made of uric acid and are not seen on IVP. You stated you had an infection. Blood in the urine can be caused by a simple infection of the bladder, which could be found on the urine analysis(U/A) A third possible diagnosis would be bladder cancer, which is everyone’s number one concern. Particularly with your history of hematuria, family history, and smoking, I would have a complete work-up. Some times bladder cancer presents with blood in the urine and irritative symptoms. Most patients usually do have symptoms, but it is possible to be free of all symptoms 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 don’t 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 don’t have a treatable condition. I would suggest you go and see a urologist for a full evaluation. To answer you other questions, it is unlikely that forceful intercourse can injure the kidney. It is also unlikely that the RBC’s present are from a previous a UTI. Cigarette smokers have up to a four times higher incidence of bladder cancer than non-smokers. The risk correlates with the number of cigarettes smoked, the duration of smoking, and the degree of inhalation. The risks has been observed in both sexes. Former smokers have a somewhat reduced incidence of bladder cancer compared to active smokers. It is said to take a cessation of 20 years to approach levels of non smokers. 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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