Dr. Madhav Tiwari
General Surgery
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
Answered by
Medically reviewed by
Patient's Query
Hello doctor,
I have had episodes of hematuria for the past six months. Generally once or twice a month these episodes will occur. The urine color would return to normal within two passes of urine. I have had a CT (computed tomography) scan with no findings. My cytology tests are also negative. Bladder cystoscopy is clear. Blood results are within range. Also, there is no infection in the urine culture. Generally, I feel fatigued and my body aches on the days these episodes occur. I do have a non-obstructive stone in my right kidney which I have had for over seven years which I am told is unlikely to be the cause. The stone is five millimeters in the lower interpolar region. Currently, I am taking Ondansetron as required and Nurofen. What could be the reason? Please help me, doctor.
Thank you.
Hello,
Welcome to icliniq.com.
I have read your query and understand your concern. I have gone through the test reports provided by you and need some extra details from you (attachments removed to protect patient identity). When was the first time you had blood in your urine? Does it only happen a couple of times a month or is it more frequent? Are you a smoker? I can see you have a strong family history of bladder cancer, is that correct? Are there any other illnesses that run in your family? Are you diabetic or have any other illnesses? Have you undergone any surgeries in the past? When you have hematuria, is it painful or painless? Have you ever passed clots or tissue bits in the urine? The CT (computed tomography) scan that you underwent, was it a contract scan or a plain CT scan?
Please share the reports of the cystoscopy and CT scan as well. Many thanks, please revert back with the details and I will do my best to assist you.
Thank you.
Patient's Query
Hi doctor,
Thank you so much for the reply.
The first episode was six months back. Random episodes maybe once or twice per month otherwise normal in between. The hematuria is painless when it does occur and no clots or tissue in urine to date. I am an ex-smoker. There is a family history of bladder cancer (dad, and aunt on my dad's side). I have a history of gall bladder removal surgery seven years back. I am non-diabetic and have no other significant illnesses. The CT scan was without contrast as I am allergic to contrast. Unfortunately, I do not have access to a copy of the cystoscopy report as it is not in my online health record, however, I was awake for it and was told it was clear and the urologist closed my file and told me to follow up with GP and public system urologist or nephrologist for further investigation and discussed with GP who said the report was clear and the suggestion was to see a nephrologist or urologist to discuss stone removal which I am on the waiting list for.
Hello,
Welcome back to icliniq.com.
I have gone through all your reports (attachments removed to protect patient identity). Let me start off by saying that it is extremely unlikely the small five-millimeter stone is causing this issue. It is possible but very unlikely. All your other organs also seem to be alright. The causes for hematuria or dark-colored urine are plenty: Liver disease (but yours looks fine on the CT scan), tumors (again not evident in your scans), infections (your reports are pretty normal), stones (need to be bigger in my opinion to cause bleeding, but still possible), inherited blood disorders, or inflammation of the kidney (glomerulonephritis).
I need some more information from you before giving my advice: Have you had any pregnancy-related issues or miscarriages in the past? Whenever you have had a small injury does your blood take a long time to clot (stop bleeding)? The normal range is between three to five minutes. My guess is that it may be a kidney issue (not stone related). However, I would still like to rule the above things out.
Thank you.
Was this conversation helpful?
Same symptoms don't mean you have the same problem. Consult a doctor now!
General Surgery
Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.
This website uses cookies to ensure you get the best experience on our website. iCliniq privacy policy
