Back in April of last year I had what was(and still is) some mild burning at the tip of the penis as well as foamy or bubbly urine in the toilet after urination. The burning only lasts about 10 minutes after urination at this time. I had a dipstick done that was normal, no blood, protein, leukocytes, etc. A month later with the same symptoms my doctor did another dipstick and said it looked like a slight infection but did not give me any details, just Cipro for 10 days which did not help. After Cipro did microscopic urinalysis which was negative. Still with symptoms, sought a urologist. He cultured the urine which was negative. Did a DRE which was normal as well as 24 hour creatinine, protein and urine volume...all normal. Second culture was normal as well. Urologist then did cystoscopy which revealed a very small 3mm urethral stricture in the head of the penis and he thinks this is the cause of the burning which is mild at this time. Rest of the urtethra was normal as well as prostate. He said he could see no lesions on the bladder wall but my bladder was full of debris such as phosphates and so could not a get a good look. This physician also suggested urethroplasy to fix stricture.
I eventually went to a noted urologist for second opinion who said the bubbles do not mean anything since I have no protein in the urine and said urethroplasty would be like "hitting an ant with a sledge hammer" and not to do the surgery. He also did post void bladder scan which was normal and another urinalysis which showed 3-5 HPF WBC and moderate debris. My question is: What is this debris in the urine and is this normal, and is 3-5 HPF WBC significant?
It seems like you have had a pretty comprehensive evaluation.
I cannot be sure what the debris is without seeing it. However, with the urine tests that have already been done - blood, protein and casts would seem to be less likely.
A WBC count of 3-5 HPF may be seen in normal individuals. Other debris such as bacteria, casts, or RBC may also be present in small amounts in healthy individuals.
Infection is the most common cause of an increased WBC urine count. Most cases of infection would exceed 10 WBC/HPF.
This option 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.
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