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Red blood cells in urine
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Red blood cells in urine

  During a routine test my doctor found red blood cells in my urine. He referred me to the urologist who ordered an ultrasound of the kidneys. this test was negative. now he wants to do a test with a scope so he can look in the bladder and where ever else it goes...
  I sas the same urologist 6 years ago for a hernia repair. At that time he found the same thing. He tested the urine two more times and is was negative. he said lots of time after a rectal exam you could see the traces of blood in the urine.  6 years ago he dropped it after the uninalysis was negative.
  my question is why now are we doing ultrasounds and scope (dont know what this called) tests?  does this sound right?
Dear Mark
Thanks for your concerned question.  
Hematuria is very common and  can be the early signs significant pathology namely; stones, infection or even cancer.  The normal work-up for hematuria is a IVP( kidney films with dye) or Ultrasound with KUB ( plain xray of the kidneys) and also a cystoscopic exam (looking into the bladder with a lighted scope).
The Xrays look for stones and tumors of the kidney.   The cystoscopy exam is necessary because small bladder tumors can not be seen  on xray. The same for small bleeding blood vessels of the prostate. Usually the cystoscopes (lighted telescopes) are flexible and much more comfortable than just a few years ago.
Approximately 30-40% of persons with microscopic hematuria ( microhematuria) have no identifiable cause ( idiopathic).  Unfortunately, we are unable to predict which patients, with previously negative work-up for microhematuria, have not  developed  a diagnosable cause several yearss later.   The guidelines for continued idiopathic microhematuria, call for  a full work-up every 3 to 5 years.  I would lean toward every three years especially if the patient smoked.  ( 4 times higher risk of bladder cancer.)
Hope this has helped and good luck with your cystoscopy.??.  
More individualized care is available at the Henry Ford Hospital and its urban campuses by calling  (1 800 653 6568). We can also arrange local accommodations through this number if this is your need. Please bring any physicians
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