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Having injury in the penis. Discomfort while passing urine. CUE test showed pus cells. What to do?

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Practicing since : 2007
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This query is for my son aged 9 years. He had a small injury on his penis when one of his classmates hit him a few months ago. It was shown to the doctor. Although my son did not reveal the fight either to me or to the doctor, the problem has apparently subsided and a CUE indicated everything as normal(There was no RBC). He used to complain about discomfort in passing urine even before that episode but it seems to be getting quite painful again now. I got a CUE done again this afternoon and it shows 4-5/HPF pus cell; 1-2/HPF Epithelial Cells; casts, crystals and others Nil; RBC Plenty/HPF. I am enclosing the report as attachment. I wish to know what other diagnostics can be safely performed to ascertain the exact cause of the problem; One Doc has advised circumcision when he was an infant but the other regular doctor who was seeing him then advised against it at that point in time. Is there any link between the then suggested surgery and this hematuria? I will take him to a doctor again tomorrow but I wish to know what will be the common meds and which are particularly dangerous; Otherwise his health is okay. Even the restlessness in sleep has come down significantly during the past few months.
Posted Wed, 5 Jun 2013 in Child Health
Answered by Dr. Imraan Hussain 17 minutes later

Thanks for your query.

I can feel your concerns.

Hematuria in your child has an obvious cause that is trauma , any bleeding vessel or small erosion inside urethra or bladder can present like it.

As in CUE cast are nil that means kidneys are safe.

Yes, of course circumcision is a better option in many ways , but it has less link with hematuria

The complication is stricture in the urethra which can be prevented earlier by cauterization.

Anticoagulant drugs are contraindicated in this case

You should consult a pediatric urologist for this traumatic hematuria.
Hope this information will be helpful to you .

Wishing him a speedy recovery.


Above answer was peer-reviewed by
Follow-up: Having injury in the penis. Discomfort while passing urine. CUE test showed pus cells. What to do? 2 hours later
Thank you very much for the prompt reply. I will certainly take him to a good childrens' doctor in a few hours from now. But, I would be happy if there is any safe diagnostic that can be undertaken to find out the exact situation. Perhaps that report will also be helpful to the attending doctor apart from saving me time from an additional visit to the doctor. Thank you.
Answered by Dr. Imraan Hussain 2 hours later
Most welcome

Pelvic ultrasonography is a simple test to see blood in the urinary bladder,
other sophisticated test include urethroscopy wheerby urethra is directly seen from inside for any lesion.

Hope so it will not be a big problem.
Avoid wearing pants with a zip .

If you do not have any clarifications, you can close the discussion and rate the answer. Wish you good health.

regards Dr XXXXXXX
Above answer was peer-reviewed by
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