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Blood in urine but no UTI--possible cancer?
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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 but no UTI--possible cancer?

I am a 50 year old female, and was diagnosed with institial cystitis in 2002. I had a DMSO instillation 18 months ago which didn't help. I have a long history of UTIs. Several times in the past couple of years, I've had the usual symptoms, but the urinalysis showed negative for infection. Now, for the second time in two months I have had visible blood in my urine. Both times the urinalysis showed no infection, just high protein and blood. Both times I had frequency, lower pain and pressure, and terrible fatigue. I am currently taking Macrobid. Last time the symptoms finally went away after 2 weeks of antibiotics. I have no insurance, so want to know if a urine cytology would rule out bladder cancer, since that seems like the least expensive test. but if it's not cancer, I don't want to pay for tests like cystoscopy or IVP. You have mentioned "trauma" as a possible cause of blood in urine. Is having intercourse a possible cause of trauma to my bladder? Both times I have had blood in my urine, my husband and I had intercourse the day before. There was some discomfort during intercourse. Is that a possible reason for the blood? If so, is there a remedy, other than abstinence? If the urine cytology is negative for cancer cells, should I pay to have the IVP and cystoscopy done? I have no cancer history in my family and am a nonsmoker. I am healthy, other than chronic migraines which started about 2 years ago.
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As you know, blood in the urine is never normal.  A urine cytology by itself is not enough to exclude the possibility of cancer.  It is not nessary to have both an IVP and cystoscopy - if the cystoscopy is negative, then an IVP would be redundant.  However, if the IVP is negative, you may want to pursue a cystoscopy (since that would be the most comprehensive test).

Trauma is a possible cause, but I would only consider this if less serious causes are ruled out.  

If the cytology is negative, unfortunately I would continue to pursue some kind of imaging study to ensure that cancer is not present.  

Another test to consider if the bladder workup is negative would be a kidney ultrasound since various kidney disorders can also cause blood in the urine.

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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