Cystitis Exam

[drjoeross]

My wife, who is 58, and in very good health had an episode of blood in her urine, pressure in her bladder and she felt very tired.  15 years ago she had cystitis and was quickly and effectively treated with an antibiotic.   Her doctor would not see her now and said she had to go to the ER.

I took her to a urologist instead.  He asked if she had frequent episodes or cystitis or other health problems, to which she answered all negative. She is very healthy, exercises, is perfect weight and does not drink or smoke. The blood in the urine was much less we told him as the day had gone by.  The only oddity,  which is still normal from what I read,  is that she is just going into menapause.  As I read on the Internet this makes her more suseptible to cystitis. This started after intercourse which makes even more sense. Before we saw the urologist, my wife was given an Ultrasound of her kidney, bladder and uterous ... all was negative. We brought that info to the Urologist.

After a thorough interview, The Urologist wanted to do a cystoscopy.  I asked if this might be problematic as she likely had an infection, so he put it off till next week.  He then insisted on inserting a catheter to her bladder and washing out blood clots as he says the presence of clots causes more bleeding by "drawing more blood."   He finally gave her an AntiBiotic.  5 hours later when we filled it she needed it as she now had a fever. This morning she is much better and there is only light orange urine.  

My question is this:  What was the value of inserting a catheter and flusing and inflamed bladder with some sort of saline solution?  Does his explanation of "blood clots drawing more bleeding"  make any sense?    I looked all over the Internet and could find no such explanation.   She does not have the symptoms of what I read is called "intersitial cystitis" as she has no recurrent episodes and is responding well to the Antibiotics.... I am not inclinded to want her to have the cystoscopy either, nor is she.  The doc was oriental and I wonder if this is some oriental persective.

Again:

1) Does the bladder wash serve any traditional allopathic medical purpose?  

2) Does it seem likely a cystoscopy makes sense next week?

My inclination is to find a new doctor.

Thanks for your time, skills and knowledge. I am techy but do not know medicine. Your help will be appreciated.

[Kevin Pho, MD]

I am not a urologist, so my insight is limited.

1) Doing a bladder wash is not unreasonable if there is suspicion of blood clots.  However, this is a debatable point and may not be done by all urologists.

2) I totally agree with a cystoscopy.  With blood in the urine, bladder cancer needs to be ruled out, and the cystoscopy is the most comprehensive test.

These questions can be discussed with your personal physician.

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.
kevinmd_

[drjoeross]

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