chances of bladder cancer

About 3 weeks ago, I had to wake up every hour or so to urinate. During the day, it felt as if I had to urinate again about 10 seconds after I went. My doctor did a dipstick urinalysis and found microscopic blood (+1), no bacteria. I had a renal ultrasound, which showed a large 4.2 cm cyst with a somewhat heterogeneous wall. A CT scan excluded a mass, classified the cyst as simple and also showed normal surrounding organs. Meanwhile, two additional dipstick urinalyses and one lab microscopic urinalysis showed no blood but a few white blood cells (leukocyte esterase +1 on 12/2, +1 on 12/6 and +2 on 12/9). A urine culture showed bacteria, but not enough to be classified as an infection. Blood work was all normal. Also, the frequency of urination problem seemed to subside. I went to a urologist anyway, who did his own urinalysis (normal), a NMP-22 test (negative), cytology (negative) and a cystoscopy (no cancer seen). The doctor said I had an overactive bladder and gave me a pill.
   Additional info: I had an adominal (abdominal) ultrasound, pelvic ultrasound and transvaginal ultrasound 7 months ago for an irritable bowel diagnosis; plus, if it matters had a completely clear colonoscopy a year and a half ago. I no longer feel the immediate urge to urinate although my bladder still gets full fairly quickly. I am a 57-year-old female who quit smoking 27 years ago.
   Here are my questions: Did the tests I have pretty much rule out bladder cancer? Should I still be concerned about the blood that showed up once in the urine? Should I be concerned about the white blood cells that have showed up? What else could have caused all these symptoms and test results?
  Thanks for your response!

[Kevin Pho, MD]

After the tests that you have had (particularly the cystoscopy), I would say that the chances of bladder cancer is very unlikely.

If there continues to be blood in the urine, periodic cystoscopies can be considered in cause a mass or lesion was missed by the prior tests.  

You have had a pretty comprehensive evaluation of the kidney as well - at this time, periodic monitoring of the urine can be done to ensure the blood in the urine doesn't worsen.

10 or more WBC in the urinalysis is considered abnormal.  Numbers less than that are not likely associated with an infection.

These considerations can be discussed 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.

Kevin, M.D.
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