Blood in Urine

[Anne Victoria]

I am a 37 year old female.  When I was 7 1/2 months pregnant in May 2004, I actually saw blood in my urine for one whole day.  I went to my gyn for a urine culture which came back negative for any UTI.  He said that it may have been caused by a prior infection that I didn't know that I had.  To be on the safe side, I went for further evaluation to a Urologist.  He gave me macrobid taken for 7 days.  After the baby was born, I went back to the URO again.  I had a trace of blood in my urine that he once again treated as a UTI and gave me macrobid.  I went back again in 1 month.  Still had trace of blood.  I did have an infection at one point and was treated with Cipro.  I went for a KUB ultrasound and abdominal CT scan.  I also had a cystoscopy.  He saw "lesions" on my bladder that looked "suspicious" and said I needed to have them biopsied in the hospital.  This was done on October 14, 2004.  Also had urine cytology done.  Thank God, they all came back negative for any cancer.  URO said it was only bladder inflammation.  About 4 days after the biopsy procedure, I started to experience pain at the end of urination.  Saw my URO for follow-up on October 27, 2004.  Told my URO about pain and he said that my urine did not show any bacteria and I did not have an UTI. It totally felt like an infection to me.  He said it was probably my bladder returning back to normal from surgery. Then on October 31, I urinated some blood (saw it).  This happened only once that day. The pain following urination subsided. I called the URO and he wanted me to have urine culture done to check for UTI.  I don't understand - I just saw him 4 days earlier and he said my urine was fine. I still have a trace of blood.  Still waiting for culture at this point.  What should I do???????????  Should I seek further opinion since I still have blood in my urine???  Could the blood be coming from the inflammation?   I don't know what my next step should be or should I just follow-up in 3 months like URO suggested.  Maybe I had some infections during pregnancy that I was not aware of.  It is hard to tell you have an infection when you are pregnant since your bladder always feels like pressure anyway.  Please give me your expert advice on this ongoing problem I have.  I have never smoked a day in my life and my general health is excellent.  Should I be taking something like cranberry pills, etc? Thank you so much for your help.
Anne Victoria

[Kevin Pho, MD]

You have had a pretty good evaluation for blood in the urine.  The cystoscopy and urine cytology are pretty good evaluations for the bladder, and the abdominal CT scan would have evaluated the kidney.  Things like kidney stones would also have been seen with the CT scan.  Infections are possible, but would have been ruled out by a urinalysis.  

Some people have unexplained blood in the urine.  Repeating periodic cystoscopies and urine cytologies is a reasonable course of action since bladder cancer would be the diagnosis you wouldn't want to miss.  

Another consideration would be a referral to another urologic opinion.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
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