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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: Kidney Stones?Forum: The Urology Forum
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Six weeks ago, I had my urine tested with a dipstick - no blood detected. The next day, I noticed some 'blood clots' on the toilet paper after urinating. The next time I urinated - I experienced gross hematuria and the toilet paper was bright red when wiping myself. There was also some discomfort on urination - similiar to a UTI.( I have had UTI's 2-3 times in the past 20 yrs) An hour or so after this started - everything was fine. However, I did go see my Dr, and the urine dipstick showed blood. He then gave me a course of antibiotics and no blood was noted in my urine on recheck. Two days ago, the same thing happened. 'Clots' noticed then next urination bloody and with some discomfort. Blood was noted for about 60 - 90 minutes after initial blood seen. After this time, no blood visible and no further discomfort. Is this a kidney/bladder stone? ( Five years ago I had severe cervical dysplasia which was CIS when treated, and also had a complete hysterectomy with salpingo/orphtectomy due to an ovarian mullerian mucinous tumor of borderline malignancy) I always thought if you had a kidney stone the pain was extreme and the pain was not of a short duration. ( Also had pneumonia and pleural effusion 10 months ago.)
Dear J. Patterson, Hematuria, blood in the urine, may come from the kidney, ureter, bladder, prostate or urethra. The cause may be due to infection/inflammation, stones, cancer, prostatic varices, sickle cell disease, or renal parenchyma lesions or glomerulopathy. The evaluation consists of a history and physical exam, a urine analysis culture and sensitivity, urine cytology, serum electrolytes, an imaging study of the kidney and ureters (CT/IVP/Ultrasound) and a cystoscopy to evaluate the urethra, prostate and bladder. From your history of gynecological cancer in the past, this may represent recurrence of the cancer with invasion into the urinary bladder. It does not sound like kidney stones which, as you stated, can be quite painful. You have painless gross hematuria with clots which makes me suspect the bladder as the source. Did you have a follow-up CT scan? What did it show? Do you pass air when you urinate? Do you leak urine? How long ago was your surgery? Did you have radiation/chemotherapy treatment as well? Were they able to remove all of the cancer? Was the pleural effusion related to the cancer? These are the questions you should present to your physician. Follow up with a Urologist is warranted. More individualized care is available at the Henry Ford Hospital and its urban campuses by calling (1 800 653 6568). We can also arrange local accommodations through this number if this is your need. Please bring any physicians' notes and lab test results that you may be able to obtain. These will help us greatly.
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