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Dark color urine and lower left back pain. Should I be concerned?

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General & Family Physician
Practicing since : 2005
Answered : 2308 Questions
ok I am kinda lost here.At this moment I am still in the ER..IVE been having really dark urine for around 8 days now photo added..I've had sum lower left back pain..I was using the restroom fine plenty of flow everytime. today I could hardly even get the 30cc of urine the ER wanted gave about 20 cc and had to strain to get that out...point is I've had UTI several times and ER said blood work was fine showed UTI that's all no other test just sum iv fluids..are they right or should I have a fellow up with my DR...29/m
Posted Sat, 30 Nov 2013 in Urinary and Bladder Problems
Answered by Dr. Prasad 44 minutes later
Brief Answer: Treatment depends on examination and investigation Detailed Answer: Hi, Dark colored urine is concerning feature which suggest presences of blood in the urine. But if the cause is related only to urinary tract infection, then you need not be very worried. Extra fluid supplementation either in the form of iv infusion or oral liquids is the important stay of treatment. That being said, I hope the doctors there have carefully excluded all other possibilities. Some of the tests that I would order if you were my patient include: 1. A per rectal examination to check your prostate. 2. If this episode followed severe physical exercise, then I would check your creatinine kinase and urine myoglobin level. 3. An ultrasound examination if not a CT scan to look for structural problems of kidney and prostate. I would also want to know if you have a stone some where in your renal system. 4. I would perform the basic renal function test - serum creatinine and BUN to evaluate renal functions. 5. Lastly I would test your platelet count, bleeding time, clotting time, PT and INR levels especially if you are on aspirin, anticoagulant therapy or any other pain killer drugs for long time. You can discuss about all these tests with the doctors there. If the doctors are convinced that they have ruled out other possibilities, you may follow up with an urologist at a later date for cystoscopy to complete the assessment. I hope this helped you. You are free to ask for doubts. Wish you a speedy recovery. Regards
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Follow-up: Dark color urine and lower left back pain. Should I be concerned? 37 minutes later
no other test where done..just urine and blood work they didn't care to even give me iv fluids..they put a iv in and never used it but to take blood...should I drive to a bigger city to a bigger hospital where maybe they know DR thought it was renal failure suppose to go see her tomorrow should I still go and ask her to run the test she planned on running even though er Dr said uti
Answered by Dr. Prasad 1 hour later
Brief Answer: Visit an urologist for a better treatment... Detailed Answer: Hi, I apologies on behalf of the doctors at ER if you haven't received good response from them. Extra fluids either in the form of oral fluid drinks or intravenous fluid is going to be important to flush out an infection and stones which are the two most common reasons for bloody urine. As I informed in my earlier reply, if the episode was not after a severe physical exertion, UTI or a renal stone would also be my first clinical diagnosis. I would order you to drink plenty of fluids if not IV fluid therapy. That being said, it is important that doctors perform other test to make sure we don't miss any important concerns. I am really not sure what test has been ordered at the ER. Since you are the at ER now, you may ask the treating doctor and learn about what specific tests were performed and the results from it. Renal failure is generally associated with pedal swelling, reduced urine output and breathing difficulties. If your feet are not swollen renal failure seems less likely. However I would definitely test the renal functions to rule out renal disease. In this context, if the doctors at the ER are not responsive, you may visit another specialty hospital where you can get an urologist to look at this problem. Alternate solution is to go back to the other doctor and discuss with her about our discussion here. She can put in her views which will allow you to take an informed decision. I wish you good luck and speedy recovery... Feel free to write back for assistance. Regards
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