HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

question-icon

Hello. I Am A 65 Year Old Female. In 2015,

default
Posted on Mon, 8 Apr 2019
Question: Hello. I am a 65 year old female. In 2015, I had a partial nephrectomy for a stage 1b tumor. My urologist told me it was not aggressive. At my last annual check up (in October) I noticed a reading of 50EYR blood in the urinalysis, which my urologist did not think was of concern, but offered a six-month scan rather than 12 months if I wanted, which I did. That scan is later this week. A couple of weeks ago, I saw pink in the toilet bowl and immediately called him and he ordered a urinalysis. (Previous to this, I%E2%80%99d noticed some very dark urine but had not been drinking a lot of water at the time and probably too much caffeine, so adjusted that and it stopped.) The urinalysis came back with normal readings except for showing 250EYR blood in the urine. The day after I saw the pink, I saw blood clearly in the bowl. That was on Saturday, March 9. I have not seen any visible signs of this since. In an email exchange, my urologist told me he is not expecting this to be something worrisome and that he often sees nonspecific urinary tract inflammation with no apparent cause. What are your thoughts on this? With my history and no other symptoms, I am very concerned. Thank you.
doctor
Answered by Dr. Manuel C See IV (1 hour later)
Brief Answer:
Kidney bladder ultrasound and urine culture is the next step.

Detailed Answer:
Good day and thank you for being with healthcare magic!

Given that your biopsy from the surgery showed a low stage disease your urologist is correct in saying that he is not worried for recurrence.

Although it would be prudent to do an ultrasound of the kidneys and bladder to be sure to rule out recurrence since you have blood in the urine. I would also get a urine culture to see if there is an infection and treat accordingly.

Infection is still the most common cause of blood in the urine and for microscopic blood in the urine a number of medical diseases can cause this like hypertension and diabetes. Dehydration may also cause blood in the urine.

I hope I have answered your question satisfactorily and please don't hesitate to ask further questions if you have any.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
default
Follow up: Dr. Manuel C See IV (1 hour later)
are you referring to a different culture than would have been done on the urinalysis that showed no issues except the blood? and is bladder involvement from previoys disgnosis a concern? last ct was in october. thank you.
default
Follow up: Dr. Manuel C See IV (2 hours later)
adding to ny folliw up. i did a home urinalysis test strip just now. shows blood in urine altho no visible in bowl.
doctor
Answered by Dr. Manuel C See IV (5 hours later)
Brief Answer:
I recommend and ultrasound or a repeat CT scan for your case.

Detailed Answer:
Good day and thank you for being with healthcare magic!

If urine culture came out with a negative result then there is no need to repeat and infection is ruled out.

Bladder is the primary consideration for any person with painless blood in the urine and should not be overlooked.

I would recommend doing the ultrasound or a repeat CT scan with contrast since it has been almost 6 months from your last. This is in light with the new development of you having blood in the urine that was not present before. Recurrence for your disease is unlikely but not imposible and we have to be sure 100 percent.

I hope I have answered your question satisfactory
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
default
Follow up: Dr. Manuel C See IV (15 minutes later)
I’m a little confused because while I was waiting to hear from you I began researching and learned that a urine culture is different from the standard urinalysis? Can you explain please? I hope you are still online and can respond quickly.
doctor
Answered by Dr. Manuel C See IV (16 minutes later)
Brief Answer:
Urine culture is different from urine analysis.

Detailed Answer:
thank you for your follow up question. urine culture is where they place your urine in aculture media and wait for the bacteria to grow. this generally takes around 3 to 5 days before the result comes out.

if this is not yet done then it is better to get a urine culture to be sure that you don't have any infection. This is the gold standard to determine whether you have a urine infection or not.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
default
Follow up: Dr. Manuel C See IV (8 hours later)
Thank you, one last follow-up. Is this fairly common in women with my history as described? Thank you.
doctor
Answered by Dr. Manuel C See IV (0 minute later)
Brief Answer:
Yes for infection.

Detailed Answer:
which is more common? infection would be a definite yes. female sex and advance age would make you prone to infection.

for bladder tumor yes equal for men and women in the 6th decade of life.

Note: Consult a Urologist online for consultation about prostate and bladder problems, sexual dysfunction, kidney stones, prostate enlargement, urinary incontinence, impotence and erectile dysfunction - Click here.

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
Answered by
Dr.
Dr. Manuel C See IV

Urologist

Practicing since :2005

Answered : 909 Questions

premium_optimized

The User accepted the expert's answer

Share on

Get personalised answers from verified doctor in minutes across 80+ specialties

159 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
Hello. I Am A 65 Year Old Female. In 2015,

Brief Answer: Kidney bladder ultrasound and urine culture is the next step. Detailed Answer: Good day and thank you for being with healthcare magic! Given that your biopsy from the surgery showed a low stage disease your urologist is correct in saying that he is not worried for recurrence. Although it would be prudent to do an ultrasound of the kidneys and bladder to be sure to rule out recurrence since you have blood in the urine. I would also get a urine culture to see if there is an infection and treat accordingly. Infection is still the most common cause of blood in the urine and for microscopic blood in the urine a number of medical diseases can cause this like hypertension and diabetes. Dehydration may also cause blood in the urine. I hope I have answered your question satisfactorily and please don't hesitate to ask further questions if you have any.