Q. I am frequently urinating and I have irritation in the urethra. Is it anything serious?

Answered by
Dr. Padmesh Jain
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Mar 21, 2021 and last reviewed on: Apr 19, 2021

Hello doctor,

I had an ultrasound done for my kidneys and bladder today due to frequent urination and irritation in the urethra. I had a CT scan without contrast four months back, which stated I had peripelvic cysts on the left kidney, but that is all it said. I was asked to come for an ultrasound of my full bladder. They scanned my kidneys, then the bladder. The technician then said, “hold on,” and left the room and came back in and said can you empty your bladder. I did, then she took more pictures of the bladder and kidneys again. Does this mean she found something abnormal in the scan? A bit scared now because I was told to have a full bladder, and then when I thought it was over, I had to empty and do it again. The second time was not as long. I had a CT without contrast a few months ago, which I have attached.

#

Hi,

Welcome to icliniq.com.

I can understand your apprehension.

But you need not worry.

As per the report images you have provided, your CT scan is absolutely fine as far as calculus (stone) is confirmed. To detect a calculus (stone), a plain CT scan without an IV contrast is sufficient as the majority of the stones are radiodense on CT. During an ultrasound examination for renal - ureteric - bladder calculus, it is important to scan the patient in a state of the distended urinary bladder. Sometimes, small stones can be missed, and backpressure changes caused due to them. To be sure, sometimes we ask the patient to urinate and then again scan them on the full bladder so that our chances of missing the calculus is decreased. However, in your case, if a competent sonographer did not detect calculus even on a repeat scan, then you may relax. (your CT scan also corroborates this). I will be happy if you could provide me with your ultrasound report and images and your CT scan images. The cause of your frequent urination could be a urinary tract infection. Kindly get a urine examination done and also check your blood sugar levels. In the case of the urinary bladder infection, on ultrasound, we can see thickening of the urinary bladder wall and significant post-void residual urine.

I hope this helps.


The Probable causes:

Urinary tract infection.

Investigations to be done:

Urine routine microscopic and pathological examination.
Complete blood count.
Blood sugar levels ( fasting, post-prandial, glycosylated hemoglobin).

Differential diagnosis:

Urinary Tract Infection.
Tiny calculi.

Probable diagnosis:

Urinary Tract Infection.

Treatment plan:

Urinary antibiotics depending on reports.
Urine alkaliners.
Drinking plenty of water or fluids.
Vitamin C.

Preventive measures:

Drinking plenty of water or fluids,
Not holding urine for long.
Control of blood sugars if diabetic.

Regarding follow up:

Follow-up with reports.
Also provide me with USG images and reports.
Provide me with CT images.

Hi doctor,

I just did the ultrasound yesterday, so I am not sure how long it will take to get the results. When I do, I will send them. I was scared that they found something serious on the scan, and that is why I had to empty my bladder so they could see it better. But they did a scan for my kidneys and bladder again. I am just worried that they did that because something bad was found.

#

Hi,

Welcome back to icliniq.com.

Do not worry. They must have done a scan again to be sure.

The other cause which may be of concern is bladder papilloma. However, it is of benign etiology and can be managed. At my clinic, we usually dispatch the report within half an hour. However, if the patient load is high or I need a second opinion, we provide the reports the next day. I pray and wish that your ultrasound report turns out to be normal. Once you get them, please share them with me for a better insight. Also, undergo the few investigations I did mention in my earlier reply and revert.

Best regards.

Hello doctor,

Here is the report.

It looks like just the cyst that I was aware of. Would they have stated if it was a concerning or complex cyst and noted follow-up? As it is written, I am assuming it to be a simple cyst. Should I worry or not worry?

#

Hi,

Welcome back to icliniq.com.

I am happy to see that your report (attachments removed to protect the patient's identity) says nothing wrong with the kidneys except for a para-pelvic (simple) cyst in the left kidney. They have reported even the urinary bladder is normal, and the post-void residue of urine is also not significant.

The ureteric jets' visualization suggests that there is no obstruction to the flow of urine from the kidneys into the urinary bladder through the ureters, which is a good sign.

If there was something to worry about, then they would have mentioned it in the report.

So you can now just relax and stop worrying.

Just follow the instructions which I had mentioned earlier and drink loads of water and do not hold urine for too long.

Let me know if you have further doubts.

I wish you good health. Take care. God Bless.

Do you think I need to ask if it is a complex cyst or would they have noted that if it looked suspicious?

Is the size concerning?

What’s the difference between parapelvic and peripelvic? On the hand written report it states Para Pelvic and on the typed report it says Peripelvic (see attached)

I’m just trying to get this all processed in my head. Would love to just forget about it and move on, but I’m not 100% sure. I appreciate your help
# Dear Wayne,

welcome back.

The usual protocol is to mention if the cyst is simple or complex. And if its not mentioned, it is presumed that its a simple cyst. I can tell if its simple or complex if you could provide me with Ultrasound images or video clip. Or simply ask them.

Though the size is little concerning, its not at all something to get worried about or panic. Don't lose your sleep over it. The usual complication which can occur in such size simple cysts is rupture or infection. Majority of the cases nothing happens. People live and die with such cysts without hampering their quality of life. So you can just forget about it and move on.

Frankly , there is no significant difference in parapelvic and peripelvic cyst. just a little variation of location. We don't use the term peripelvic here though

My only advice will be to get an ultrasound scan done every year or two to see for change in size or appearance of the cyst.

there is nothing to be worried about.
wishing you health and happiness.
Take care. God Bless

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