Hi, After going through your history, the possibilities for the flesh like pieces in urine and pain with urination are either long standing urine infection or a kidney problem called papillary necrosis (portions of kidney tissue die and get passed out in urine, especially in diabetics). Long standing infections, especially those caused by fungus, can lead to fleshy whitish soft pieces being passed in urine. Kidney stones can predispose to urine infections. Please check your urine microscopy which can show increased number of WBCs and bacteria or fungus in appropriate tests. Please collect the fleshy piece. Giving this for examination can find out whether it is due to infection or sloughing of kidney tissue. The diagnosis of papillary necrosis may require a computed tomography of abdomen with contrast injection. Other rare conditions are tumors, which are probably not the cause in your case, since your ultrasound is normal and there is no blood in urine. I am available provide any clarification you need, Wish you a speedy recovery, Dr. Raguram.