What Causes Occasional Blood In Urine?

Posted on Mon, 10 Aug 2015

Question: I am a 62 year old white male, taking high blood pressure medication, and paroxetine for anxiety. I have had an ongoing problem of occasional blood in my semen since my 20's. I have also had a problem, which may or my not happen concurrently, of a very small amount of blood coming out of my urethra after I urinate and have a bowel movement. It seems the bowel movement causes the slight bleeding, maybe a drop or less of red blood that causes spotting. Sometimes there is a very, very slight pain like a small cut would give near the end of my penis. I have seen several doctors over the years about this, both general practitioners and urologists. They check me out and give me reassurance that it is generally okay, It may happen about once a year. I get very nervous when it happens. It goes away on it's own. The slight spotting from my urethra happened again, and I have an appointment with a urologist. I most recently saw a urologist in 2007. Do you have any comments on my situation? Thank you.

Answered by Dr. Dr. P. T. Patil (5 hours later)

Brief Answer:
Needs Evaluation.

Detailed Answer:
Hello
Thanks for your query ,based on the facts that you have posted it appears that you have occasional hematuria since age of 20 years and on investigations the cause of hematuria could not be traced out

I shall be happy if you can post me few more details to help me in making comments on your problem.
1) Do you have other urinary symptoms like frequency for urination .urgency ,poor stream etc?
2) Did you ever had Hematospermia (Blood in semen ) any time?

Occasional blood in urine is mostly due to rupture of tiny superficial vein on the surface of Prostate due to mild infection and in absence of any other urinary symptoms has no significance

Please get your routine urine test and urine culture done to find out the organisms causing this infection and antibiotics to which they are sensitive to.

Please take broad spectrum antibiotics like Cefixime along with urinary antiseptic like Nitrofurantoin twice daily and urine alkalizer thrice daily .Later on switch on to appropriate antibiotics as per culture report.

Get the prescription of medicines from your family Physician.

Ensure to drink more water .To keep your urine dilute This will help to control dysuria.

Please consult qualified Urologist for clinical and digital rectal examination and get following basic
tests done to confirm the diagnosis.
1) Urine routine and culture.
2) Ultrasound scanning of abdomen and pelvis
3) Serum PSA.
4) Endoscopic Examination of bladder (Cystoscopy).

Further treatment will depend upon result of these tests and final diagnosis.

Hope I have answered your query ,please feel free to ask if you have more questions ,I shall be happy to help you
Thanks and Regards.
Dr.Patil

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. Chakravarthy Mazumdar