Microscopic Hematuria and diagnostics

[honeybeekeeper]

My wife (51) had a UTI last fall for the first time in probably 20 years. There was some blood in the urine, which is not unusual with a UTI.  She developed second UTI in the spring, and the blood count was high (150), and a urine cytology was ordered (neg).  She developed a third UTI mid summer, high blood count (250), and another cytology (neg), ultrasound (normal), and referral to a urologist.  The urologist ran a culture panel, and it came back negative, and then did a cystoscopy, (blood and cytology reports not yet back), but the bladder looked healthy and normal.

We were expecting a CT scan next, but instead, the urologist said she was unsure if the bladder was emptying completely, so she said at my wife's next appointment, she will perform and in office ultrasound, with a full bladder (transabdominal), and then a another after the bladder is "emptied" (transvaginal).

So far, no source of the blood in the urine has been found.  I can't seem to find any info on how a [partially emptied] bladder could, or would, relate to Microscopic Hematuria, and how this second ultrasound can help locate the source. Honestly, I don't understand how a CT scan could locate such tiny blood loss either.  

Any help or comments welcome.

[honeybeekeeper]

Yes, she will absolutely have this ultrasound, but the first ultrasound indicated the "ureters not visualized", and the urologist said it was because they were too fine to be picked up.  So now, the urologist will be doing her own ultrasound, but even adding in the transvaginal ultrasound, it doesn't seem possible to get a look at the ureters from that perspective either, or at least not much of them.  So what does this screening look for, general structural abnormalities?

[Dr J Singh]

Hello,
Microscopic hematuria can be due to urinary tract (bladder) infection,swelling in the filtering system of the kidneys ,stone in bladder or in a kidney,blood disease, like sickle cell anemia,certain medicines and tumors in the urinary tract.

Although cystoscopy is the desired test but sometimes ultrasound may be needed to look for any stones or tumors in the kidneys or ureters.So I would suggest you to comply with the urologist and get ultrasound done.

I hope that helps.Take care and regards.