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trace hematuria
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trace hematuria

I am a 41 year male who exercises regularly.  I had a routine UA and it resulted in a finding of 2 to 4 RBCs.  The specific gravity was 1.033 which was above the upper limit of 1.030.  However, this was morning urine and my urine throughout the day is clearly much less concentrated.  Doctor thinks that this is likely nothing other than joggers hematuria.  Additionally, I take 81mg of aspirin as prevention for heart disease as i have significant family history.  A couple of days before the test I took 650mg prior to a jog.

What would the appropriate testing be, if any, to follow up?  Cyctology?  CAT? etc?
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On the basis of this single urinalysis I would not make any decisions. I would get three separate MID-STREAM urinalyses at least a day apart. If two or more of these have more than the upper limit of normal RED CELLS (not just dip-stick positive), then I would recommend a full work-up for hematuria. This consists of a CT Urogram (specially tailored cat scan that shows early and late phases of the excretion of the x-ray dye), as well as a cystoscopy (looking into your bladder with a narrow telescope) to examen the inside of your bladder. X-rays do not well show the bladder lining) and I  would not assume that this is just "jogger's hematuria" without ruling out other causes. I recommend getting a urine cytology along with the rest of the work-up. Joggers can get tumors and make stones. The aspirin does not cause  bleeding in the urinary tract but may help to keep it going.
Good luck!
S.A.Liroff, M.D.
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