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I am menopausal. Noticed bleeding while passing urine. Urine test and ultrasound done. Any suggestion?

DOCTOR OF THE MONTH - Mar 2016
Mar 2016
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OBGYN
Practicing since : 2011
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I had sent my earlier question to one of your team doctor on 18 Feb, presuming that I had Gynae problem, but Dr. Soumen answered and I done urine test again and then urine culture report and showed to Urologist in New Delhi on 25 Feb. He further advised to get the ultra sound done. (all reports are attached for your reference please.). Kindly advise next course of action and what could have done exactly to me.
PREVIOUS QUESTION AND ANSWER ATTACHED.
hello, doctor, am 45 old lady with total menopause stage. today, i had sudden bleeding problem while passing urine. as advised by my gynae, i undergone urine test wherein my epithelial cells are 10-12 and albumin is +. what does that mean pls.Asked by Me , Mon, 18 Feb 2013
Doctor's reply to your question above...
Hello,Thanks for writing to us. I am trying to give answer as per your concern.According to your history, you have menopausal stage for near about 3 yrs. Now, you get bleeding in urine (hematuria) and undergo one urine test with above findings.There are three types of epithelial cells present in urine and normal level is zero to few only. These include 1) Transitional epithelial cells-normally found. 2) Squamous epithelial cells- indicates contamination. 3) Renal tubule epithelial cells- suggest renal disease. In general, epithelial cells should not be present in a urine sample. But most common cause of high amount of epithelial cells (10-12) is improper collection of the urine or contamination with vagina or other things. Here, you need to repeat the urine test again by ruling out contamination to exclude major underlying pathology like bladder tumor/ renal disease as you get hematuria with high number of epithelial cells and mild proteinuria (1+) .Otherwise it indicates lower urinary tract infection (UTI) which is more prevalent in women and can cause mild hematuria with trace amount proteinuria (albumin 1+). Generally, it is less complicated if treated with proper antibiotic therapy & urine alkaliser.Another thing, with above two findings & hematuria, we can't reach in pin point diagnosis. Therefore, I suggest to consult with urologist for complete physical examination, investigations and proper medication. You may need to undergo some other tests like hormone level assay/ Renal Function Test/ Cystoscopy/ Intravenous Pyelography (IVP) etc to exclude or confirm underlying renal/ bladder pathology if you get abnormal report again in repeat urine test. In the interim, do the following things:1) Take healthy diet with low protein diet with avoidance of salty/ spicy foods.2) Drink plenty of water or fluids (3 lit plus) to stay hydrated and remove body toxins.3) Maintain genital hygiene properly before & after each sexual intercourse and toileting.4) Wear only clean and cotton underwear and does not use chemical/ irritant substance.5) Check BP in regular interval as hypertension may cause hematuria or other renal disease.6) Do regular light exercise by walking/ jogging and eat more vegetables & fruits.7) Keep bladder empty in periodic interval and do not pressurize your bladder.Hope, above information is very much sufficient for your understanding. If you have any further questions I will be happy to help.Wish your good health in future and please focus on next line of investigation & treatment.Regards,Dr Soumen.
Posted Wed, 20 Mar 2013 in Women's Health
 
 
Answered by Dr. S Patra 1 hour later
Hello,

Thanks for posting your query and attaching necessary reports.

I have reviewed all your attached reports including recent ultrasound scan and past urine examination report. But recent urine examination report is missing or mistakenly uploaded with wrong one.

Can you please upload or attach recent urine examination report once again? It helps me to give much elaboration about your present condition with suggestive measures.

I am waiting for your response and newly attaching urine report.

Regards,
Dr Soumen
Above answer was peer-reviewed by
 
Follow-up: I am menopausal. Noticed bleeding while passing urine. Urine test and ultrasound done. Any suggestion? 19 hours later
Dear Doctor,
as desired please
 
 
Answered by Dr. S Patra 1 hour later
Hello,

Thanks for uploading another urine culture report.

Your ultrasound report (USG scan) is quite good and almost normal except two things. These are

1) Multiple small gallstone- you may require surgical treatment regarding this if you are symptomatic. In such cases general surgeon can help you.
2) Para pelvic cyst- at lower pole of the left kidney. It is very small in size and rarely needs any treatment. Here, you have nothing to worry.

Now, your urine report including culture is mostly suggestive of lower take proper antibiotic therapy (like ofloxacin/ norfloxacin etc) along with urine alkaliser. Taking cranberry juice is quite helpful in treating the same.

Follow these things (as I previously mentioned) strictly to prevent future infection & complication:

1) Take healthy diet with low protein diet with avoidance of salty/ spicy foods.
2) Drink plenty of water or fluids (3 lit plus) to stay hydrated and remove body toxins.
3) Maintain genital hygiene properly before & after each sexual intercourse and toileting.
4) Wear only clean and cotton underwear and does not use chemical/ irritant substance.
5) Do regular light exercise by walking/ jogging and eat more vegetables & fruits.
6) Keep bladder empty in periodic interval and do not pressurize your bladder.

Hope, I have answered your query. If you do not have any further query, you can close the discussion & rate the answer.

Take care yourself and don't be much worried.

Regards,
Dr Soumen.
Above answer was peer-reviewed by
 
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