Womens Health

Blood in urine (cont'd)

No, there are no other medical conditions - No diabetes. I did have pyelography already (I was injected with Iodine, then X-Rays were taken). This was also inconclusive.

Then the only additional study necessary is to have urine specimens collected for cytology to check for malignant cells. If that test is negative then nothing further needs to be done.

I know it is very frustrating to have blood in the urine and not know what is causing it. Remember that everyone passes some red blood cells in their urine. It is just a matter of how many are there.

Occult (no visible blood) hematuria is quite common. Note in the abstract below, most asymptomatic microscopic hematuria in women is due to insignificant areas of bladder inflammation.


Int Urogynecol J Pelvic Floor Dysfunct 1999;10(6):361-4
Asymptomatic microscopic hematuria in women: case series and brief review.
Singh GS, Rigsby DC
Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia 19104, USA.

Recommendations for the work-up of asymptomatic microscopic hematuria (AMH) often derive from studies including both men and women. This study was undertaken to determine whether that work-up is appropriate for a female patient population. We studied 49 women referred to a urogynecologist for AMH.

Patients underwent formal urinalysis, urine culture and cytology, cystoscopy, and either renal ultrasound or intravenous urography (IVU). Highly significant lesions diagnosed were one renal cell carcinoma and one acute tubular necrosis (ATN). Moderately significant lesions included one candidal urinary tract infection.

Insignificant lesions included bladder inflammation in 46 patients and renal cysts in 5. Our findings confirm the importance of the work-up of AMH in women. Ultrasound was effective in diagnosing upper tract lesions, with less cost and morbidity than IVU.

Larger studies are needed to determine who should be screened, whether the work-up should differ for younger women, possible treatments for benign findings, and appropriate follow-up.

What is the treatment for large kidney stones?

I have a kidney stone that I believe the nurse said is 10 cm. What kind of treatment do you think the doctor with use? Will he laser it or is it too large? What kind of recovery period is there?

The usual management of kidney stones has a medical and surgical approach. Once a stone is identified treatment consists of watchful management in stones less than 5 mm until you spontaneously pass the stone.

Stones that are less than 2 cm but more than 5mm in diameter are best treated with shockwave lithotripsy alone. Stones more than 2 cm in size or those greater than 1cm and in the lower poles of the kidney may be treated with percutaneous nephrostolithotomy.

This involves inserting a scope-like instrument into the kidney through a small incision in the back or side. This may be what your doctor will recommend.

After treatment, the prevention of future stones should be addressed and this often requires analyzing the stone itself and implementing proper treatment from there. Discuss with your doctor the options of treatment and how you can prevent stones in the future.

Table of Contents
1. Urinary tract infections
2. Urethral syndrome
3. Blood in pee?
4. Treating urethral syndrome
5. Recurrent cystitis
6. Bladder feels full
7. Reasons for blood in pee
8. Kidney stones
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