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Blood in urine, burning urination, vaginal burning. Taking Butabil. Worried about bladder cancer. Can this be the cause?

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For a number of years I had trace blood in urine samples and doctors said nothing to worry about. The last one that said that was in 1999 and I was 54. Since then the annual physicals that I have had didn't do a urinalysis. Yesterday I had one done because I have had burning, not when urinating and frequency of urination, but mostly the burning in the vaginal area not when urinating. The urine specimen showed a lot of blood in urine and the doctor sent the specimen off to the lab. I am concerned because she said it may be bladder cancer but also that there were many other causes. I never have blood in urine that I can see. I do take a lot of butabital (up to 6 pills a day) and usually feel the burning after. I am only taking one a day now to get off medication. Do you think this may be the cause of the blood in urine?
Posted Sun, 10 Jun 2012 in Urinary and Bladder Problems
Answered by Dr. V. Sasanka 7 hours later
Considering that you have had blood in urine for a number of years, hopefully it is not bladder cancer which is what we worry about when we wee a 60+years old patients with Red blood cells in urine.
We do recommend that the urine sample be examined for cytology for malignant cells which can be positive in a higher grade tumour or some early cancers as well. But as your physician has pointed out, a lot of other conditions also can cause blood to appear in urine.
Some of them include medical kidney conditions and need a nephrologist to assess further. They are also associated with loss of protein in urine, and may be associated with use of ant-arthritic medication or some auto-immune conditions or simple high blood pressure, etc.
I hope a baseline ultrasound examination can be done as it will be able to tell us what is the status of kidneys.
A more detailed assessment with the newer 64-128 slice CT scan of Kidneys and Urinary Bladder can be done if a stone or tumour is suspected.
Sometimes, a cystoscopy may need to be repeated especially with a special light source if a strong suspicion of malignancy exists. At the same sitting, urine from both ureters can be collected independently and examined for pathology. Also a tube can be passed into each of the ureters (tubes connecting kidneys to bladder) and a contrast XXXXXXX can be sent up and a special radiograph called RGP can be taken which gives a very good assessment of the possible cause.
Once we localize the source, site of the bled, more specialized endoscopes can be sent to the sites to biopsy them if necessary.
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Follow-up: Blood in urine, burning urination, vaginal burning. Taking Butabil. Worried about bladder cancer. Can this be the cause? 3 hours later
Since the clinic has sent the specimen to the lab for urinalysis, is it customary for the lab to examine it for cytology?
Answered by Dr. V. Sasanka 10 hours later
The answer to your question is -Usually no.
Unless the lab has been specifically asked by the referring physician for cytology, the conventional urine analysis is commonly performed by a technician, and overseen by a biochemist if there is an issue.
Urine cytology is usually sent as a separate sample, and the examination is conducted by a pathologist who would have had some prior experience in these matters, as it is very easy to miss a malignant cell, and vice versa - it is quite common to see some inflammatory cells being labelled malignant by inexperienced observers.
Above answer was peer-reviewed by
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