Urology Expert Forum
Blood in urine kidney stone (teenager)
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Questions in the Urology forum are answered by medical professionals at Healthcare Magic. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.

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Blood in urine kidney stone (teenager)

My teenage son (15 & not yet sexually active, so far as I am aware) recently experienced significant blood in his urine.
This first presented several hours after he received a knock in the back when playing rugby. (No bruising or rib damage).
He did not feel unwell enough to prevent him from continuing to play and has not been in pain since this ocurred.
The bleeding sounded significant as it was..."more like tomato ketchup than weak tea." He advised my wife & I of this 2 days later, by which time the bleeding had become less noticeable.
Our GP examined him and took a urine sample which showed slight evidence of blood, but no evidence of any growths or infection. The GP also checked blood pressure, which was normal. My son did indicate that there was some tenderness when the GP pressed to one side of his stomach. Subsequently, my son's urine & general health appear to be normal. (5 days later).
On the GP's advice, my son had a CT scan & visited a urologist.
The scan covers his abdominal region and shows no sign of abnormality on any of the organs...other than a small kidney stone.(My son has a habit of not drinking water during / after sport, but otherwise has a reasonably healthy diet).
The urologist is uncertain as to the cause of the bleeding, but thinks that it is unrelated to the rugby knock...and may be related to the kidney stone or a prior one. He has suggested a day surgery proceedure, to be undertaken in several week's time, which I understand involves examining the bladder & kidneys internally, by passing a scope up through my son's penis. (Cystoscopy?)
I would be grateful for your opinion as to what might have caused the bleeding and whether the day surgery procedure should be taken sooner rather than later.
I should add that I had a kidney removed in my early 20's..I am now 53. This was congenitally malformed / small / inefficient...and had never given rise to similar symptoms.
It may also be relevant to note that one of my brother's in law has had recurring kidney stones.
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A cystoscopy would be a comprehensive procedure to evaluate the bladder and urethra, however given your son's age, I think that the yield would be low.

Infection, trauma, exercise, kidney disease as well as unexplained causes are all potential etiologies.  

If the cystoscopy is negative, I would suggest a kidney ultrasound for further evaluation.  

If that is negative, then it may certainly be from the trauma or exercise and I would repeat the urine sample on a periodic basis to see if the blood is gone.  

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.

Thanks,
Kevin, M.D.
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