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hematuria w/ associated flank pain
by croman761, Mar 11, 2008 06:20PM
Approximately six weeks ago, I went to the doc with general stomach pains. My urine sample showed WBC and RBC and I was given a course of macrobid. I felt better for a couple of days and then within one week, felt worse. I went back and they did not do a culture the first time and the WBC was higher. So, they gave me a course of Levaquin. The next day I began to have flank pain that was reminiscent of a previous episode with a stone. I did a "home remedy" involving diet soda and asparagus. I felt better the next day and saw what could be described as four pieces of black sediment in the toilet the next day. Flash forward approximately five weeks later and I begin experiencing gross hematuria on Friday and Saturday morning again, felt some "grabbing" in my side. I again did the home remedy and on Monday, saw my doc. The gross hematuria was gone but was still +++ on the test with trace protein, sp. gravity at 1.010 and no WBC. It was sent for a culture. Culture was negative.Everything else on the urinalysis is fine, excpet for the RBC. Friday rolls around again and I am having more pain in my side and gross hematuria again. I go to an urgent care facility. The doc sees WBC and RBC under scope and starts me on Cipro for five days. I saw my regular doc on Monday and there is still a trace of WBC and +++ RBC. (not gross). The pain in my side is a dull ache now, not grabbing and sometimes goes as far down as my pelvic area. The doc thinks maybe a stone is stuck somewhere. They did a KUB set of xrays and I have not gotten results yet. I have had some frequency/urgency issues in the past year but have been told they are normal given my age of 47, female and obesity. I am wondering what the possibility is that it is bladder cancer, even though my pain is in the kidney area and radiating down what seems to be the ureter. Thanks for your help!
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I understand you are highly anxious about this.The presence of red blood cells and protein in the urine requires further evaluation. An underlying infection, a kidney stone, a disease of the kidney subunits or glomerular disease, bladder disease and other systemic diseases such as diabetes,immunologic disease and structural abnormalities in the urinary tract are differentials.
A CT scan of the kidney,ureter and bladder, a 24 hour urine collection ,and blood tests for uric acid,calcium and phosphate levels are necessary. Determination of BUN and creatinine levels are also important.
Do you have other associated problems like diabetes or hypertension?
Can the calcifications be stones, or is it more likely to be renal cell carcinoma? Thanks for the help, Vanessa!
We can not really tell at this point since an X ray is usually best in identifying calcified structures like bones .It is not the best tool in visualizing soft tissues.
I know you are worried about this but renal CA is fairly uncommon and in your case the more common conditions need to be ruled out first.A renal stone may be a primary diagnosis in your case. The CT Scan will be able to guide your physician in better visualizing the structures.
Blood tests like serum calcium and phosphate,BUN ,creatinine,hormone levels, a complete blood count,a 24 hour urine collection for urinary protein and serum albumin levels may be necessary.
Keep us posted regarding your results.