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Urologist or Internal Med?
Symptoms: Chronic microhematuria, fatigue/malaise, severe bilateral flank pain/bone pain, achey lower central abd/pelvic pain, and unrelenting severe night sweats.
History: Right dermoid ovarian cyst, Post menopausal per supracervical hysterectomy-No HRT due to Mothers non hormonal r+ breast CA, +smoker, light etOH use. Grandmother (maternal side) had hx DM and also died of Bladder CA, Bothers and mom also have microhematuria.     History of vertigo and MRI shows ovoid lesions in corpus collusum/High T1 and suspected demyelination  but neuro says NOT MS.  Got more insignificant Hx, but I just think it's time to get this looked at again.  
Have seen urologist in past for cystos and IVP's (about 3 years ago), but no longer have complete insurance coverage. My most severe symptom is the back *bone pain with the night sweats. Who should I go see? My IM MD or my old urologist?
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1711789 tn?1361311607
Hi there!

Well, without a clinical evaluation it would be difficult to determine the cause of your symptoms. Possibilities that may need to be considered include renal causes such as bergers disease, infections, inflammations, calculi, growths/ masses, gynaecological issues such as endometriosis, hormonal/ endocrine imbalances etc. The back ache may or may not be related to the other symptoms, though we would need to keep cancer high in the list due to a positive family history. I would suggest starting with the IM MD initially since you may need to see a nephrologist and/ or a urololgist. Depending on the condition diagnosed/ suspected it can be managed accordingly or specialist care may be sought.
Hope this helps.

Take care!
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1711789 tn?1361311607
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Thank you for your response. After a lot of testing and 'pictures', my IM doc referred to a medical oncologist for my bladder as well as an orthopaedic oncologist for my spine.
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