What causes blood in urine and frequent urination?

Question

Hello doctor,

I am a 36-year-old male experiencing the following symptoms for the past 2 months:

Frequent urination.
Burning sensation after urination.
Blood in urine (hematuria) on three occasions.
Urgency to urinate after drinking liquids.
Cloudy urine after consuming dairy products like yogurt.

Tests and findings so far:

Urine test: No infection detected but noted crystallization.
Prostate ultrasound: White spots identified, urologist suggested infection and prescribed Doxycycline (3 weeks), but symptoms persisted.
Prostate-specific antigen (PSA) blood test: 1.7 (normal range <1.4 at this lab; my PSA 3 years ago was 1.3 with a different normal range of 0–4).
Persistent lower back pain at the lumbosacral (L5-S1) region.

Questions:

What could be causing my symptoms? Was the urologist's diagnosis of infection correct?
Could I have prostate cancer, bladder cancer, or another serious condition?
Is there a connection between my back pain at the Lumbosacral (L5-S1) region and my urinary symptoms?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Burning during urination and blood in the urine (hematuria) could be due to an underlying condition such as a kidney or ureteral stone. Stones can also cause back pain, particularly in the lumbosacral (L5-S1) region, if the stone obstructs or irritates the urinary tract. Since males are less prone to urinary infections compared to females, it is important to identify any underlying cause.

At your age, prostate cancer is highly unlikely, and a PSA (prostate-specific antigen) test is generally not necessary unless there are other risk factors or significant clinical suspicion. Similarly, bladder cancer is rare at 36 but cannot be completely ruled out.

A computed tomography (CT) urography is recommended as it is more sensitive than an ultrasound for detecting small stones in the ureters, which an ultrasound may miss in approximately 10 percent of cases. Avoid starting antibiotics like Doxycycline unless a clear diagnosis of infection is made, as unnecessary antibiotic use can lead to side effects and resistance. Stones in the urinary tract could explain most of your symptoms, including the hematuria, burning sensation, frequent urination, and back pain.

It is important to proceed with further imaging and investigations to confirm the diagnosis and guide appropriate treatment.

I hope I have answered your query.

Let me know if I can assist you further.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

I read your query and can understand your concern.

Whenever there is blood in urine problematic things should be ruled out. Congestion extremely rarely causes blood in urine. In last 10 years I have seen only three patients with bladder cancer in this age group.

I hope I have answered your query.

Let me know if I can assist you further.

Thank you.