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Urology (Expert Forum)
radioactive iodine
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.
radioactive iodine
by val__0, Dec 28, 1998 12:00AM
I am a 45 year old female that recently had radioactive iodine
for hyperthyroidism. Three days later I got what seemed to be
a urinary tract infection. The culture came back negative and
antibiotics didn't help. This was a month ago, the symptoms are
gone but I now have blood in my urine. My doctor seems to think
that I have stones of some sort. Is it possible that the radioactive
iodine has caused an irritation my bladder?
================================================
Dear Val,
I looked up several Iodine labled medications used to treat thyroid cancer and did not find hematuria or bladder irritation as a side effect. You may want to ask your doctor or pharmacist to look in the PDR or literature, specifically looking for hematuria associated with the drug your took. In general, hematuria in particular gross hematuria needs to be worked-up and identify a cause for the blood in the urine. There is a percentage of patients that undergo a complete hematuria work-up that is negative and this may be your case. However, it is suggested that you be evaluated by a doctor to determine if this work-up needs to be performed.
Hematuria is the medical term for your condition. It is important to have a microscopic cell count done to determine if this amount of hematuria needs to have a full work-up. Above 3 RBC/HPF is suggestive of significant hematuria that needs work-up.
A full work -up consists of a history and physical to direct the studies ,an IVP , a cystoscopy which should be done by a urologist, and a cytology looking for cancerous cells in the urine. About 30% of patients at our institution have some pathology causing there hematuria.
A urinary stone could be a possibility, however, an IVP would be needed to identify it. Some stone are made of Uric acid and are not seen on IVP.
You could also have an infection. If you are febrile and have flank pain , you should be evaluated for a possible kidney infection. Also, blood in the urine could be caused by a simple infection of the bladder, which it sounds like your doctors treated you for. This could be found on the Urine analysis(UA).
A third possible diagnosis would be bladder cancer. To be complete, I have included this diagnosis, and I don’t mean to scare you. Some times bladder cancer presents with blood in the urine and irritative symptoms. These patients usually do not have flank pain , but it is possible depending on the size and location of the tumor. This is why we perform cystoscopy, to rule out any suspicious lesions in the bladder. The cystoscopy also allows the urologist to examine the anatomy of the bladder and position of the ureteral openings in the bladder.
Our last diagnosis would be idiopathic, simply meaning, we don’t know. Patients that exercise or have bleeding disorders can often have blood in their urine without a good explanation. These patients get the same work-up listed above to ensure they don’t have a treatable condition.
I would suggest that you have a repeat UA and if the microscopic analysis is high, RBC>3/HPF, go and see a urologist a full evaluation.
This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Sincerely,
HFHS M.D.-AK
*keyword:Hematuria
for hyperthyroidism. Three days later I got what seemed to be
a urinary tract infection. The culture came back negative and
antibiotics didn't help. This was a month ago, the symptoms are
gone but I now have blood in my urine. My doctor seems to think
that I have stones of some sort. Is it possible that the radioactive
iodine has caused an irritation my bladder?
================================================
Dear Val,
I looked up several Iodine labled medications used to treat thyroid cancer and did not find hematuria or bladder irritation as a side effect. You may want to ask your doctor or pharmacist to look in the PDR or literature, specifically looking for hematuria associated with the drug your took. In general, hematuria in particular gross hematuria needs to be worked-up and identify a cause for the blood in the urine. There is a percentage of patients that undergo a complete hematuria work-up that is negative and this may be your case. However, it is suggested that you be evaluated by a doctor to determine if this work-up needs to be performed.
Hematuria is the medical term for your condition. It is important to have a microscopic cell count done to determine if this amount of hematuria needs to have a full work-up. Above 3 RBC/HPF is suggestive of significant hematuria that needs work-up.
A full work -up consists of a history and physical to direct the studies ,an IVP , a cystoscopy which should be done by a urologist, and a cytology looking for cancerous cells in the urine. About 30% of patients at our institution have some pathology causing there hematuria.
A urinary stone could be a possibility, however, an IVP would be needed to identify it. Some stone are made of Uric acid and are not seen on IVP.
You could also have an infection. If you are febrile and have flank pain , you should be evaluated for a possible kidney infection. Also, blood in the urine could be caused by a simple infection of the bladder, which it sounds like your doctors treated you for. This could be found on the Urine analysis(UA).
A third possible diagnosis would be bladder cancer. To be complete, I have included this diagnosis, and I don’t mean to scare you. Some times bladder cancer presents with blood in the urine and irritative symptoms. These patients usually do not have flank pain , but it is possible depending on the size and location of the tumor. This is why we perform cystoscopy, to rule out any suspicious lesions in the bladder. The cystoscopy also allows the urologist to examine the anatomy of the bladder and position of the ureteral openings in the bladder.
Our last diagnosis would be idiopathic, simply meaning, we don’t know. Patients that exercise or have bleeding disorders can often have blood in their urine without a good explanation. These patients get the same work-up listed above to ensure they don’t have a treatable condition.
I would suggest that you have a repeat UA and if the microscopic analysis is high, RBC>3/HPF, go and see a urologist a full evaluation.
This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Sincerely,
HFHS M.D.-AK
*keyword:Hematuria
