Blood in Urine - No Stones

Posted by Bruce on May 17, 1999 at 17:37:21
During a recent physical, blood was found in the urine. I had a kidney stone 3 years ago, and an IVP at that time so the doctor set me up for a ultra-sound on my kidneys and bladder this time.
No stones could be seen. I now have an appointment with a urologist. I am 44 years old, male, never smoked, no family history or bladder cancer. I don't have any burning during urination or any other symptoms. Like everyone else, I am concerned about the trip to the urologist and a diagnosis of cancer. Would anything have shown up on that ultra-sound and how worried should I be of a major problem? (cancer)

Posted by HFHS M.D.-CK on May 18, 1999 at 11:02:49

Dear Bruce,
Microscopic amounts of blood in the urine (microhematuria) requires evaluation.
The differential diagnosis includes many things both cancerous and benign.  The evaluation involves excretory urogram  (IVP) an x-ray study of the kidneys and ureters with contrast dye, a urine cytology (microscopic examination of urine looking for cancer cells), and a cystoscopy (looking into the bladder and urethra with a flexible lighted telescope in the clinic setting).  A pathologic finding is not always found, some kidneys leak a few extra red blood cells into the urine.
Renal ultrasound can detect tumors of the kidney and findings of obstruction.  If the ultrasound was normal, it is doubtful that you would have a sizable kidney tumor.  However, the ultrasound does not rule out tumors in other areas of the urinary tract.
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. The Henry Ford Hospital Department of Urology has experience in the evaluation and treatment of problems such as you describe. We would be most interested in helping you. You can reach us through our toll-free number (1-800-653-6568). We can also arrange local accommodations through this number if this is  your need. Please bring any x-rays [and pathology slides] (not just the reports) as well as any physicians