Question Title: Fam. history of bladder cancer/ blood in urine/infection

I have a history of hematuria of +1 that was diagnosed in 1996.
My old doctor told back then that it is nothing to be concerned
about because I'm very young ( in 1996 I was 26 years). No tests
were performed.

A recent urine test (requested by my new primary doctor)found
RBC 4-5 /HPF, Squamous epithelial cells :moderate, Bacteria:
Few in addition to occultblood +1 present in my urine sice 1996.
During the same visit a dipstick test reveald the presence of
occult blood in my rectum + nonactive hemoroids (I also suffer of
constipation).

My new doctor recomanded that I go see a urologist for the blood in
the urine and schedule a colonoscopy for the blood in the rectum.

Yesterday I saw the urologist. The urine test performed in her
office found infection. I was given Cipro 500mg. I started to
take my first pill today.
Next week I will be having an MRI of abdomen and pelvis +/- gadalinium
for hematuria.

**About 5 month ago the nurse practitionar who performed my PAPsmear also
found infection in the vagina and uterus bleeding. She prescribed
Flagil 750mg.

Since probably the two infections have both become an issue about the same time, is it possible they are related? It is possible that the occult blood
in rectum to be also related in any way? Would hemorroids cause blood in urine?

Considering my history (father with bladder cancer recently diagnosed) what other tests shoud I go for (my insurance allowed for flexibility) Should I consider genetic counseling? Is there the possibility of malignancy in my system? Any other sugestions greatly appreciated.

*******Last month my father was diagnosed with bladder cancer. Three
days ago he had cystoscopy trasurethral surgery. Surgeon removed one 2cm by 2cm tumor growth and 2 other smaller tumors. We are anxiously awaiting the resules of his biopsy results.

Deeply concerned for my health,
Giselle

Dear Giselle,
Bladder cancer is not considered a highly genetic risk between generations. Bladder cancer often stems from repeated irritation of the bladder lining with harsh chemicals over time. It sounds like you have hematuria, but in the face of infection. You should be treated for this infection and them have your urine analysis( UA) repeated. If it still shows hematuria, a work-up should be completed. If you can document several negative urine analyses, a work-up may not be necessary. A full work -up consists of a history and physical to direct the studies ,an IVP which is a study to look at the kidney anatomy and ureteral anatomy, a cystoscopy which should be done by a urologist to look for bladder pathology, and a cytology looking for cancerous cells in the urine. About 30% of patients at our institution have some pathology causing there hematuria.
I’m sure you are anxious about your father and your own situation, but I don’t believe in random testing to look for a problem. If you have an infection, this is a good reason for your to hematuria. If the blood in the urine clears after the infection is treated, I don’t think you need to have a further work-up. Talk to your doctor before you have an MRI and ask what they are looking for. If you are at high risk for bladder cancer, than you may want to have it done.
In regards to the infection on your PAP smear, I don’t think these two infections are related. One sounds like a bacteria, and the other sounds like yeast. However, if your yeast infection came directly after taking the antibiotic, they may be related.
No, hemorrhoids would not cause hematuria, and the only way the occult blood would be related is if the antibiotics caused you to have blood in your stool. Often antibiotic can eliminate the normal bacteria in the bowels or vaginal area. This allows other bacteria or yeast to grow. This may cause infection from colonizing bacteria or even yeast.
I do wish you and your father well, but I think a logical approach to each problem needs to be followed. If a bunch of random tests are ordered without a system involved, they may only further confuse the original issue.
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,
HFHS M.D.-AK
*keyword:Hematuria

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