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Having Mild Pain In Groin Area. Found Blood In Urine. Could It Be Minor Hernia?

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Posted on Wed, 26 Dec 2012
Question: Dear Doctor,

My name is XXXXXXX XXXXXXX Male, 38 years. I live in Denmark for last 4 years. Around one month back I went to my doctor here because I was having a mild pain near my groin area. It was very mild pain. My doctor checked me with his hand and he said that he feels that I have very minor hernia and should not bother much about it at the moment. If it becomes really serious then he might suggest hernia surgery,

But he asked me to give a urine sample in his clinic and asked to wait, After 15 minutes he came back and told me that he has found some blood in my urine. So I was diagnosed with Hematuria. Doctor did not rule out the possibility of it being a chronic. Though, I have never experienced any serious pain in abdomen or kidneys. Though, I could not see any blood in my urine even though it has been yellow in color for last many years but my doctor said that it is microscopic hematuria in which you leak blood cells in urine and they are not visible easily. He took several blood samples from me that day and asked to come again after 10 days to see if I am still bleeding in my urine. Unfortunately, even after 10 days I still had hematuria. But other unfortunate thing was that he found no problem in my blood samples. He said that my blood samples did not show any problem in my kidneys or liver etc. Also, my hemoglobin according to him was OK. Next, he transferred my case to urology specialist in Govt hopitals. As it works in Demark here. The urologist has not met me personally as yet but I think he has started with my case already because few days back I got a call from hospital to come for a city scan. Yesterday, my city scan was done for bladder and kidneys in which they had given some contrast in my arm which they say will go through kidneys and bladder. I dont know what are the results. Now I have an appointment with urologist on 05 Dec. I was told by the nurse in hospital that the urologist will perform cystoscopy on me. And, now I am scared till death. She told me that he will put a small tube with a camera inside my penis to see my bladder. Doctor, please suggest me what should I do? Shall I go ahead.? I am really very scared. I have been reading on the Internet about this and have found very mixed reactions, Some have mentioned that it is very painful and some say it is not painful but only uncomfortable. Doctor, in India we usually try to treat with medicines first and then see if any test is required. Why these people are not trying with a medicine first. Do you think i should first see if any medicine may cure my disease. I am really very scared. I have not even eaten food since yesterday because of this stress. If you can suggest some medicine to try out first then I will go with your suggestion and will request to postpone the cystoscopy here.
please guide.

Best Regards XXXXXXX XXXXXXX
doctor
Answered by Dr. Rajiv goel (59 minutes later)
Dear XXXXXXX

You had pain in the groin and were found to be have microscopic hematuria on examination. All other tests were within normal limits. I would have subjected yourself to ultrasound at that point of time itself and if required even CT scan. Going by your history you had a stone in your ureter and it caused all these complaints. I would have managed yourself conservatively and probably asked you to repeat your scan as well urinalysis few weeks down the XXXXXXX

I think you are jumping the gun at this point of time and the doctor is not going to suggest you for a cystoscopy. You should start yourself on alpha blockers such as tamsulosin under the care of your urologist and repeat urinalysis after few weeks.

However, if there is hematuria even after few weeks of treatment, then you should undergo cystoscopy especially if you are a smoker.

Hope I have answered your query. Let me know if I can assist you further.
Above answer was peer-reviewed by : Dr. Mohammed Kappan
doctor
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Follow up: Dr. Rajiv goel (57 minutes later)
Hello Doctor,

Thank you for your quick response. The nurse told me yesterday when I went for CT scan. That urologist will have cystoscopy next week. I am not sure if this is sure or is it just a guess of her. But if it is true then what should I tell him so that he can postpone the cystoscopy and go by some medicines rather as you have suggested. CT scan was performed yesterday and nurses told that the results will be discussed next week itself when I XXXXXXX the doctor. Doctor, how did you conclude that I had a stone in my ureter.
I am totally non smoker. Never smoked in my life. I do drink very very occasionally and not more than one peg. Doctor, what if I ask the urologist here about the medicine which you have suggested. I dont think I can get them here without prescription. Its very restricted here in terms of pharmacy. Dcotor, I had bought a home-based urine test strips here from the pharmacy. And evertime I go to pee, I test my urine with a strip. I have noticed a strange thing. When I go to pee after eating something like after lunch or dinner, the strip turn dark XXXXXXX to prove there is blood but when I have not eaten any food and pee only after drinking some water, the color of strip is very light XXXXXXX which should mean less count of blood in urine. What do you think of this? Doctor, can we talk on phone also?

Best Regards XXXXXXX XXXXXXX
doctor
Answered by Dr. Rajiv goel (2 hours later)
Dear XXXXXXX

Your symptoms are suggestive that you had stone disease and it shall be hopefully picked on the CT scan and nothing more shall required to be done.

You can discuss the issue at length with the urologist and also ask him to prescribe the medications as suggested. As you are non smoker, your chances of having malignancy are very minimal and hence you don't merit cystoscopy on the first go.

The change of color dipsticks with intake of food has little clinical significance and hence i shall not bother about it. I will suggest yourself to relax and stop worrying. You have no major problem and nothing major needs to be done.

All the best

Sincerely

Rajiv Goel
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Rajiv goel (4 hours later)
Thank you, Doctor.

I will get back to you with more information after my meeting with the urologist on 5 Dec. I hope am able to convince him to start medication and not go for cystoscopy.

Thanks again.

Regards XXXXXXX
doctor
Answered by Dr. Rajiv goel (8 hours later)
Dear XXXXXXX

Tell the doctor your symptoms in detail and also the very fact that you are non smoker.

Sincerely

Rajiv Goel
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Rajiv goel (4 hours later)
Thank you, Doctor.

Will do as suggested.

Regards XXXXXXX
doctor
Answered by Dr. Rajiv goel (10 minutes later)
Dear XXXXXXX

Take care. All the best.

Sincerely

Rajiv goel
Above answer was peer-reviewed by : Dr. Mohammed Kappan
doctor
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Follow up: Dr. Rajiv goel (3 days later)
Dear Dr. XXXXXXX

As mentioned to you in my earlier messages, I had gone for my meeting with my urologist today. And as I had expected, they wanted to start with my cystoscopy immediately. But As suggested by you I talked to the urologist first to explain my view-point. I asked him that since, all my tests are coming normal, why does not he starts with some medicines first to see if the symptoms go away and then he can do one uranalysis after some days. He said he can not prescribe me any medicine before cystoscopy as this is the part of their routine checkup here in Denmark. They give any medicines only if they found some thing wrong otherwise no.

But he gently told me that its totally upto me if I am not comfortable with the test right now and I can come later when I make up my mind and for now he will close my case and send it back to my general physician. Infact, he himself mentioned that in majority of cases cystocopy shows normal bladder. And, probably it may be the case with me also.

Doctor, I firmly said him that right now I dont want to go for this invasive scan. And if I really feel something very serious then I will come back.

Doctor, you were suggesting some medicines to me. One of my friends is coming to Denmark from India this week. Do you think I can go with the medicines suggested by you? I can ask my friend to bring those medicines for me.

Best Regards XXXXXXX XXXXXXX
doctor
Answered by Dr. Rajiv goel (12 minutes later)
Dear XXXXXXX

The hospitals/clinics will have specific protocols to follow and they stick to them.

I fully agree with your viewpoint. You can tell your friend to get Tab Tamsulosin (0.4 mg) for yourself and take in once a day for 4 weeks. Repeat your urinalysis after 4 weeks. This is against the policy of prescribing medicine without examination.

Good luck

Sincerely

Rajiv Goel
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Rajiv goel (1 hour later)
Thank you, Doctor XXXXXXX

Yes, doctor, I understand fully the rules and regulations here. But I just want to give a chance to medication first to see if can help me. Specially, if such medicines are light and not harmful. If it wont help then definitely I will go with any test suggested to me. The main reason is that I do not feel any pain or problem anywhere in my body. My urine frequency is also OK as in past. I really dont feel there is any major problem in me.

Thanks a ton to you. But sorry doctor, this will not be my last message to you. I will still keep you updating. with my progress with the medicine.
And,

I take the responsibility, Doctor.
:)
Do you think I have a prostate problem by any chance? I am 37 years old only.
Thanks again. XXXXXXX
doctor
Answered by Dr. Rajiv goel (1 hour later)
Dear XXXXXXX

Take care; you don't have anything to worry. The medicines are very safe and have very minimal side effects.
You don't have prostate problem. Take the medications for 4 weeks and you shall be fine.

Sincerely

Rajiv Goel
Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Rajiv goel

Urologist

Practicing since :1998

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Having Mild Pain In Groin Area. Found Blood In Urine. Could It Be Minor Hernia?

Dear XXXXXXX

You had pain in the groin and were found to be have microscopic hematuria on examination. All other tests were within normal limits. I would have subjected yourself to ultrasound at that point of time itself and if required even CT scan. Going by your history you had a stone in your ureter and it caused all these complaints. I would have managed yourself conservatively and probably asked you to repeat your scan as well urinalysis few weeks down the XXXXXXX

I think you are jumping the gun at this point of time and the doctor is not going to suggest you for a cystoscopy. You should start yourself on alpha blockers such as tamsulosin under the care of your urologist and repeat urinalysis after few weeks.

However, if there is hematuria even after few weeks of treatment, then you should undergo cystoscopy especially if you are a smoker.

Hope I have answered your query. Let me know if I can assist you further.