Question Title: Do I need a cystoscopy?

I moved into a new house about six weeks ago. After two days of lifting heavy furniture up and down several flights of stairs, I had blood in my urine in the evening. It happened twice more that night, but was gone the next morning. I never had any burning or frequency of urination or anything else abnormal.

I went to a urologist the following week, who took a urine sample and said he found no blood in it. He also felt around my testicles and inside my rectum and said everything seemed normal.

Just to make sure everything was alright, he scheduled an IVP, which also came back normal. At the time of my first appointment with him, he said that since I was a young man (26, non-smoker), he didn't think I would need to have a cystoscopy, just the IVP.

After the IVP came back normal, his nurse called and said that the doctor decided I should have the cystoscopy after all, just to make absolutely certain everything was okay. When I questioned her on his previous statement, she said that he went back and forth trying to decide if I should have one and finally decided, yes, I might as well, just in case.

To the point. I'm scheduled to have the cystoscopy next week, but am now considering cancelling the appointment. I've read that there are risks with cystoscopys and the procedure itself sounds rather unpleasant. I have not had any blood in the urine since that one night six weeks ago.

Do you think I should have the procedure done? If I had bladder cancer wouldn't the blood have continued or at least come back again by now? Isn't it highly likely that the blood was caused by my straining something or popping a blood vessel from all the lifting?

Any advice you can give would be appreciated.

Dear J.C.,
Blood in the urine is referred to as "hematuria". If you can see the blood with the naked eye it is referred to as "gross hematuria". This is not normal. Many possible causes exist. Blood can enter the urine anywhere along the urinary tract from the kidneys to the end of the penile urethra. Infection, stones, abnormal blood vessels, tumors (kidney, ureter, bladder, prostate, urethra), and trauma are all possible causes.
The evaluation includes the IVP (intravenous pyleogram, excretory urogram) of the kidneys and ureters, a cystourethroscopy (a visual inspection of the lining with a lighted telescope), and a urine cytology (microscopic inspection of the urine looking for cancer cells). The yield in your case in regards to finding a cancer will be low because of your young age and the clearing of the blood in your urine. However, bladder cancers, for example, can occur at any age and this should be ruled out in the face of a history of gross hematuria.

This information is provided for general medical information purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available through our department at the Henry Ford Hospital and its suburban locations (I-800-653-6568).
Sincerely;
HFHS M.D.-CK
* Keyword: gross hematuria

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