CT Scan Needed?

[paulpelican]

After urinating one day last week, I noticed a very, very small amount of blood on the toilet paper after wiping myself.  This only occurred once and I haven't noticed any other problems since.  I went to a urologist yesterday and had my urine tested.  The test came back and everything was normal.  Now, the doctor wants me to get a pelvic CT scan, but  I'm wondering whether or not this is really necessary.  The scan is going to cost me somewhere in the area of $750, even with my insurance.  I don't make a lot of money, so $750 is a whole lot of money for me to spend on a test that may or may not be necessary.  Should I have the test done or wait a week or so to see if I notice anything else unusual?

[Dr_Veena]

Hi,
     Thanks for keeping me posted. Actually as someone mentioned diagnosing is a step by step process, eliminating the possible causes. But in your case you had only one time minimal bleed, and no other accompanying symptoms.
So, it is better to go with less invasive procedures initially like ultrasound abdomen or an IVP, than a CT scan. Any ways, a CT scan would reveal if any abnormality in the morphology of the organs is present.
I would suggest that you take a second opinion of a urologist in this regard.
Best.

[keyzersoce]

I am not a doctor, but have been through this process. I believe doctors are trained to eliminate, in a step-by-step process, the reasons for your urinary bleeding. The initial urine testing eliminated infections, etc. as the cause, so the next step is a CT scan to check for kidney stones and the like, as mentioned by Dr._Veena. If that does not show any possible cause, a cystoscopy will be performed. You're in charge of your treatment, so ask lots of questions until you're satisfied with the answers.

Good luck.

[paulpelican]

I felt absolutely fine until about two days ago when I started to notice a stiff lower back and some very dull pain/pressure in my groin and the lower right side of my abdomen.  If there is something wrong, will the CT Scan catch it, or is there a possibility that even more testing will be required?  If the CT Scan will work as a catch all, then I'd be more than willing to shell out the money, but if I would have to pay for additional testing, I don't know . . .

[Dr_Veena]

Hi,
     How are you? Bleeding is classified by when it occurs during urination, which may indicate the location of the problem. Diagnosis is made with the help of history, symptoms and investigations.

Do you have any other symptoms like burning sensation, discharge, abdominal pain, flank pain, urgency, frequency etc? The family history may reveal inherited predispositions to kidney stone disease, sickle cell anemia, von Hippel-Lindau disease, or another genetic disorder associated with hematuria.

A thorough physical examination is performed, with emphasis on the urinary tract, abdomen, pelvis, genitals, and rectum.
Then a urine analysis can be done. If any  thing abnormal then a cystoscopy and IVP can be taken up. Cystoscopy, is performed when the cause of gross or microscopic hematuria cannot be identified. IVP produces a better image of the kidneys, ureters, and bladder and can reveal stones, tumors, blockages, and other possible causes of hematuria.

In case the doctor still has a suspicion then a ultrasound and CT scan can be done. I would suggest that you take a second opinion in this regard.
Hope this information helps.
Best.