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Noticed Blood In Urine. Advised No Infection. What Could Be The Reason?

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Posted on Wed, 11 Dec 2013
Question: I am 43 yr man generally having a normal health. No specific illness so far. I had a voluntary discharge of blood through the urinary track some time in the midnight 3 days back. I did not even come to know about the same till next day morning. It was not only the blood but a fluid (thin urine like) mixed with blood. It was sizable (around 150-200 ml) as all my inner wears were having stains all around. I consulted a physician. He noted that my BP was on a higher side 160/110. (this is a surprise since always it is 80/120 as I check this frequently - once in 2 weeks as I have a family history) He got all the routine checks done. All of them are normal. He advised that since there is no infection observed, there is no need to worry. If this repeats we will get the sonography done. This has never occured earlier and also my urine is always normal. But since the discharge was quite substantial I am worried. What can be rthe reason? Can some one help me? Should I take second opinion.
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Answered by Dr. P. T. Patil (1 hour later)
Brief Answer: It needs to be investigate in detail. Detailed Answer: Hello Thanks for your query,based on the facts that you have posted it appears that you have passed substantial quantity of blood (Hematuria)through urethra during sleep. Though you do not have any urinary symptoms and your routine tests do not reveal any positive evidence of infection ,macroscopic hematuria of such a high magnitude needs to be investigated in detail to find out the source of bleeding. Please consult qualified Urologist for clinical evaluation and get following tests under his guidance to help to come towards cause of bleeding. 1) Routine urine test and urine culture to find out the organisms causing this infection and antibiotics to which they are sensitive to. 2) Ultrasound scanning of abdomen to find out any lesion in the kidney or bladder. 3)Plain C.T scan of the urinary system and C.T scan with Intravenous Contrast.to rule out any mass lesion in kidney or bladder. 4) If needed he may decide to get endoscopic examination of bladder(Cystoscopy). 5) Complete Haemogram with coagulation profile. Further treatment will be decided by him depending upon results of these tests and final diagnosis. Hope I have answered your query. If you have any more questions please feel free to ask me I shall be happy to help you . Thanks and Regards. Dr.Patil.
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. P. T. Patil

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Practicing since :1971

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Noticed Blood In Urine. Advised No Infection. What Could Be The Reason?

Brief Answer: It needs to be investigate in detail. Detailed Answer: Hello Thanks for your query,based on the facts that you have posted it appears that you have passed substantial quantity of blood (Hematuria)through urethra during sleep. Though you do not have any urinary symptoms and your routine tests do not reveal any positive evidence of infection ,macroscopic hematuria of such a high magnitude needs to be investigated in detail to find out the source of bleeding. Please consult qualified Urologist for clinical evaluation and get following tests under his guidance to help to come towards cause of bleeding. 1) Routine urine test and urine culture to find out the organisms causing this infection and antibiotics to which they are sensitive to. 2) Ultrasound scanning of abdomen to find out any lesion in the kidney or bladder. 3)Plain C.T scan of the urinary system and C.T scan with Intravenous Contrast.to rule out any mass lesion in kidney or bladder. 4) If needed he may decide to get endoscopic examination of bladder(Cystoscopy). 5) Complete Haemogram with coagulation profile. Further treatment will be decided by him depending upon results of these tests and final diagnosis. Hope I have answered your query. If you have any more questions please feel free to ask me I shall be happy to help you . Thanks and Regards. Dr.Patil.