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Urology (Expert Forum)
Re: Blood in urine
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
Re: Blood in urine
by hfhs M.D.-AK, Jan 01, 1995 12:00AM
Posted By HFHS M.D.-AK on August 31, 1998 at 17:22:02:
In Reply to: Blood in urine posted by Chris on August 23, 1998 at 17:29:05:
My mother has been having problems c occasional blood in her urine. Other symptoms include, R flank pain and burning c urination. She went to see a family practice doctor and he said that her IVP test was negative and that the blood in her urine was rated as a 2+. The doctor didn't know what was causing the problems. Do you know what could be causing her problem?
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Dear Chris,
Hematuria is the medical term for your mothers condition. It is important to have a microscopic cell count done to determine if this amount of hematuria needs to have a full work-up. Above 3 RBC/HPF is suggestive of significant hematuria that needs work-up.
A full work -up consists of a history and physical to direct the studies ,an IVP which has already been done, a cystoscopy (looking into her bladder with a telescope like instrument) which should be done by a urologist, and a cytology looking for cancerous cells in the urine. About 30% of patients at our institution have some pathology causing there hematuria.
Considering the symptoms that your mother has, a urinary stone could be a possibility, however, with a negative IVP this would be less likely. Some stone are made of uric acid and are not seen on IVP.
She could also have an infection. If she is febrile and her flank pain continues, she should be evaluated for a possible kidney infection. Also, blood in the urine could be caused by a simple infection of the bladder, which could be found on the Urine analysis (U/A). If she has a bladder infection, She may just wait until it clears. If the U/A is negative, the cystoscopy may not be necessary.
A third possible diagnosis would be bladder cancer. Some times bladder cancer presents with blood in the urine and irritative symptoms. These patients usually do not have flank pain , but it is possible depending on the size and location of the tumor. This is why we perform cystoscopy, to rule out any suspicious lesions in the bladder. The cystoscopy also allows the urologist to examine the anatomy of the bladder and position of the ureteral openings in the bladder.
Our last diagnosis would be idiopathic, simply meaning, we dont know. Patients that exercise or have bleeding disorders can often have blood in their urine without a good explanation. She may also have muscle-joint pains independent of her hematuria to account for her back pain. These patients get the same work-up listed above to insure they dont have a treatable condition.
I would suggest your mother have a repeat U/A and urine culture and if the microscopic analysis is high, RBC>3/HPF when she is not infected ,go and see a urologist for a full evaluation.
This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Sincerely,
HFHS M.D.-AK
*keyword:Hematuria
In Reply to: Blood in urine posted by Chris on August 23, 1998 at 17:29:05:
My mother has been having problems c occasional blood in her urine. Other symptoms include, R flank pain and burning c urination. She went to see a family practice doctor and he said that her IVP test was negative and that the blood in her urine was rated as a 2+. The doctor didn't know what was causing the problems. Do you know what could be causing her problem?
--------------------------------------------------------
Dear Chris,
Hematuria is the medical term for your mothers condition. It is important to have a microscopic cell count done to determine if this amount of hematuria needs to have a full work-up. Above 3 RBC/HPF is suggestive of significant hematuria that needs work-up.
A full work -up consists of a history and physical to direct the studies ,an IVP which has already been done, a cystoscopy (looking into her bladder with a telescope like instrument) which should be done by a urologist, and a cytology looking for cancerous cells in the urine. About 30% of patients at our institution have some pathology causing there hematuria.
Considering the symptoms that your mother has, a urinary stone could be a possibility, however, with a negative IVP this would be less likely. Some stone are made of uric acid and are not seen on IVP.
She could also have an infection. If she is febrile and her flank pain continues, she should be evaluated for a possible kidney infection. Also, blood in the urine could be caused by a simple infection of the bladder, which could be found on the Urine analysis (U/A). If she has a bladder infection, She may just wait until it clears. If the U/A is negative, the cystoscopy may not be necessary.
A third possible diagnosis would be bladder cancer. Some times bladder cancer presents with blood in the urine and irritative symptoms. These patients usually do not have flank pain , but it is possible depending on the size and location of the tumor. This is why we perform cystoscopy, to rule out any suspicious lesions in the bladder. The cystoscopy also allows the urologist to examine the anatomy of the bladder and position of the ureteral openings in the bladder.
Our last diagnosis would be idiopathic, simply meaning, we dont know. Patients that exercise or have bleeding disorders can often have blood in their urine without a good explanation. She may also have muscle-joint pains independent of her hematuria to account for her back pain. These patients get the same work-up listed above to insure they dont have a treatable condition.
I would suggest your mother have a repeat U/A and urine culture and if the microscopic analysis is high, RBC>3/HPF when she is not infected ,go and see a urologist for a full evaluation.
This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Sincerely,
HFHS M.D.-AK
*keyword:Hematuria
