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Urology (Expert Forum)
haematuria significant?
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
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.
haematuria significant?
by aliaat, Jun 11, 2004 12:00AM
Hi!
22yr F, never been sexually active & never drink. November ’03 diagnosed w/transverse myelitis, clinically probable MS (thoracic spine/multiple brain lesions). ANA 1:160 homogenous, no other features of Lupus. Since, have had urinary urgency , frequency, and retention.
2 weeks ago, severe lumbar back pain which woke me at 5am, spread around to abdomen. This has somewhat abated, still need to use codeine sometimes though. Now, some water retention, upper abdomen feels bloated and hard, abdominal discomfort (sometimes pain, mainly nausea) in addition to aforementioned urinary problems with “dribbling?” and even more frequency (>10 times in 14hrs). Also, a little concerned that I cannot seem to get enough air in, breathless most of the time, even lying down. No fever or pain on urination (but then, I have decreased sensory anyways after the spine inflammation), just feeling very tired & “brain fog”.
One week ago, on urine Stix testing after flank pain worse on lying down, microscopic haematuria. Sample sent to lab mid-week came back negative for infection but still RBC (2-3 cells?). Today again traces of blood on Stix testing. Going for ultrasound within next couple of weeks. My questions are:
1) Is this microscopic haematuria significant?
2) What would cause this apart from apart from, say, bladder irritation?
3) If this were due to irritation only, would I get feeling of bloating & nausea with flank & abdominal cramping/discomfort?
4) Concerned, since microbiology came back negative, that this may be related to autoimmune activity.
Any thoughts on any of this? I don’t know if I should be concerned at this point. Thank you for your time!
22yr F, never been sexually active & never drink. November ’03 diagnosed w/transverse myelitis, clinically probable MS (thoracic spine/multiple brain lesions). ANA 1:160 homogenous, no other features of Lupus. Since, have had urinary urgency , frequency, and retention.
2 weeks ago, severe lumbar back pain which woke me at 5am, spread around to abdomen. This has somewhat abated, still need to use codeine sometimes though. Now, some water retention, upper abdomen feels bloated and hard, abdominal discomfort (sometimes pain, mainly nausea) in addition to aforementioned urinary problems with “dribbling?” and even more frequency (>10 times in 14hrs). Also, a little concerned that I cannot seem to get enough air in, breathless most of the time, even lying down. No fever or pain on urination (but then, I have decreased sensory anyways after the spine inflammation), just feeling very tired & “brain fog”.
One week ago, on urine Stix testing after flank pain worse on lying down, microscopic haematuria. Sample sent to lab mid-week came back negative for infection but still RBC (2-3 cells?). Today again traces of blood on Stix testing. Going for ultrasound within next couple of weeks. My questions are:
1) Is this microscopic haematuria significant?
2) What would cause this apart from apart from, say, bladder irritation?
3) If this were due to irritation only, would I get feeling of bloating & nausea with flank & abdominal cramping/discomfort?
4) Concerned, since microbiology came back negative, that this may be related to autoimmune activity.
Any thoughts on any of this? I don’t know if I should be concerned at this point. Thank you for your time!
Doctor's Answer
by Kevin Pho, MD, Jun 13, 2004 12:00AM
, Jun 13, 2004 12:00AM
To answer your questions:
1) Typically, hematuria is defined as more than 2 RBC's per high-power field. With this is mind, there is no "safe" lower limit where significant disease can be excluded.
2) Other potential causes can include a kidney stone, infection, bladder mass or intrinsic kidney disease.
3) It is possible that the irritation can cause the accompanying symptoms of bloating, nausea. Flank and abdominal pain may point towards a kidney stone being a cause. I would consider a helical CT scan to rule this out.
A urology referral would be the appropriate next step to evaluate this.
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.
Medical Weblog:
kevinmd_b
1) Typically, hematuria is defined as more than 2 RBC's per high-power field. With this is mind, there is no "safe" lower limit where significant disease can be excluded.
2) Other potential causes can include a kidney stone, infection, bladder mass or intrinsic kidney disease.
3) It is possible that the irritation can cause the accompanying symptoms of bloating, nausea. Flank and abdominal pain may point towards a kidney stone being a cause. I would consider a helical CT scan to rule this out.
A urology referral would be the appropriate next step to evaluate this.
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.
Medical Weblog:
kevinmd_b
Member Comments (2)
by ParkerP, Jun 12, 2004 12:00AM
To: Misc.
0
by aliaat, Jun 12, 2004 12:00AM
To: Misc.
0
