Hi. Your doctors can do a urinalysis with RBC morphology, if they have not done this already. This test can identify if the blood in the urine is coming from the kidneys itself or from lower down in the urinary tract (e.g. bladder, ureters). A repeat cystoscopy may also be warranted if the hematuria episodes continue. Your doctors may also want to consider testing the urine for tuberculosis. This is a relatively rare condition, but blood in the urine with no apparent cause is sometimes an initial symptom of genitourinary tuberculosis.
What other additional test would you recommend should the hematuria episodes continue?
Thank You for your help
dyykjt1
Hi. Since you have had an extensive work-up and all the tests have not yielded anything significant, then I would have to agree with the present course of action. Benign hematuria is a diagnosis of exclusion, and I am not comfortable giving such a diagnosis. However, all your tests have come back normal, so I would agree to just observe for the meantime and just do additional tests if an episode of hematuria occurs again.
I have followed your advice and had a complete gyn exam. Every thing was normal with no problems. I also have had extensive blood work done which is all normal. No bleeding problems. All test are normal.
I have obtained a second opinion from my gyn and from my primary care physcian who is an internist and they both agree with my urologist that this is benign hematuria that needs to be followed closely.
I have an appointment with my urologist again in August for a complete checkup.
Do you agree with this course of action?
Thank You
dyykjt1
Hi. If your urologist is at his wit's end, try to get a second opinion from either a gynecologist or an internal medicine specialist/ nephrologist. Maybe they can see the problem from a new perspective. Anyway, I hope that whatever it is, it's not anything serious. Good luck.
Dr. Roque
Thank you for your reply. No my urologist has not considered a gynecologic source for the bleeding. I have an appointment for my yearly physical with my gyn next Thursday and I will discuss this with him. I also have not had any test to check for abnormal bleeding parameters. I will check into this also.
I have been considering a second opinion, but I have had all the test to investigate hematuria. I do not know whether a second opinion would bring any additional info into this or not. Do you think I should get a second opinion from another urologist or should I wait until after I have investigated this from a gynecologic veiwpoint?
Thank You
dyykjt1
Hi. Have your doctors checked for a possible gynecologic source of the bleeding? Sometimes blood coming from the vaginal canal gets admixed with urine when voiding. Maybe the blood isn't coming from your urinary tract at all. Another thought: have your doctors checked if you have any blood problems (e.g. abnormal bleeding parameters)? This might be another possibility worth pursuing.