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Patient's Query
Hello doctor,
My uncle is 62 years old. He had CAD post-PTCA (eight years back) and hemorrhoids. Today he had blood in the urine with occasional burning micturition. He recently got a few routine investigations, including urine analysis, which shows 4-6 pus cells, and USG abdomen showed grade 1 prostatomegaly and grade 2 fatty liver. He denies flank pain, nocturia, polyuria, urgency, frequency, dribbling, hesitancy, or straining to urinate but has occasional weak stream and dysuria. No history of fever, DM. He is a chronic smoker. One of the doctors advised to get a complete urine evaluation and PSA levels. The tests show occasional RBCs, and PSA is 0.9. Does my uncle need a further evaluation? Does he need to take Tamsulosin, and can constipation lead to hematuria? Kindly guide us on what should be the plan ahead? What management would you recommend? What do you think is the reason for hematuria?
Hi,
Welcome to icliniq.com.
The probable reason for hematuria here will be cardiac drugs. He needs to stop Clopitab (Clopidogrel) for a few days, at least until the hematuria settles. He needs to continue Tamsulosin, and a dose of antibiotics for five days may also help the infection part of any. If the hematuria recurs, then he will require further evaluation in the form of cystoscopy. A uroflowmetry and urine culture will help here.
The Probable causes
Patient's Query
Thank you doctor,
He has not yet started Tamsulosin. I wanted to know if he should start Tamsulosin? His urine analysis states he still has occasional RBCs and HPF. What do you think might be the reason for that? The culture reports are awaited, and I will keep you updated on the same. And also, I wanted to know if constipation would lead to hematuria?
Hi,
Welcome back to icliniq.com.
Yes, he needs to start and continue Tamsulosin. His urine RBCs will be seen for a few days to a few weeks atleast. But if the hematuria is gross, then he will need further evaluation. Constipation sometimes can cause hematuria cause when he strains. There can be minimal blood ooze from the prostate. He will be better with a dose of antibiotics.
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