Thank you for asking on HCM Based on your details, you have a condition called terminal hematuria (presence of blood in urine at the end of urination) that indicate that the problem is localised in bladder or prostate (for men). Black specks are stone particles that sometimes are eleminated via urine. Most likely diagnosis is bladder stones with/or urinary tract infection. A complete urine analysis and an abdominal ultrasound with confirm the diagnosis. Generally, bladder stones should be removed. If the stone is small,I may recommend: - Drink at least one large glass of liquid every hour. - Avoid foods that irritate the bladder: caffeine, alcohol, tomatoes, citrus, and spicy foods. - Drink cranberry juice to help fight bladder infections. If you dislike the taste of plain cranberry juice, mix it 1:1 with another juice, such as orange juice. However, because bladder stones are often caused by the inability to empty the bladder completely, spontaneous passage of the stones is unlikely. Almost all cases require removal of the stones. Bladder stones are often removed during a procedure called a cystolitholapaxy where a small tube with a camera at the end (cystoscope) is inserted through your urethra and into your bladder to view the stone. Your doctor then uses a laser, ultrasound or mechanical device to break the stone into small pieces and flushes the pieces from your bladder. The antibiotic that I would prescribe for you is Bactrim 960 mg one tablet twice daily for five days, and for the pain Pyridium 100mg three times daily for 1 to 2 days (this drug turns urine orange, but nothing to worry). Kindly rate my answer as helpful. Dr. Elton