Hello - thanks for asking your question.
You note recurrent UTIs. You have had a very thorough urology workup include an IVP, cystourethrogram, cytology and cystoscopy. This would exclude most of the structural causes for recurrent UTIs. This would also exclude most of the causes for the blood in your urine. The only other test I would suggest would be a renal ultrasound to see if your kidneys are responsible for the blood in the urine.
Scar tissue may certainly be a possibility. Without examining you I cannot say for sure. Make sure that the bacteria is sensitive to the antibiotics you are taking. Tests for STDs (i.e. Chlamydia and gonorrhea) should be performed if not already. Some women have a genetic predisposition to receiving recurrent UTIs (i.e. more bacteria may adhere to the lining of the urethra in some women).
One consideration would be continuous antibiotic prophylaxis. Studies show a 95 percent decrease in recurrent UTIs. Most recommendations suggest a six month trial of antibiotics followed by observation. You may want to discuss this 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.
Thanks,
Kevin, M.D.