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Noticed small, whitish/ translucent, worm-like thing after urination. No pain. What can this be?

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After urinating, I noticed a small, whitish/ translucent, worm-like thing wriggling in the water in the bowl. At first I thought it had been in there already, or fallen in from my clothes (like maybe something had dropped on me from a tree outside), but then I started to wonder if I had urinated it out. Before long it stopped moving. I took it out of the bowl with the blunt side of a pair of scissors, laid it on the counter and looked at it. Outside the water, it was white. It was about 1 or 1.5cm long, 1mm wide and very delicate -- in fact, it started coming apart even though I was only gently poking it. I'm pretty sure it had been alive. I have no pain, bleeding, cloudiness, or any other symptoms of any kind. Could I have passed this thing, and do you have any idea what it might be?
Posted Mon, 11 Nov 2013 in Urinary and Bladder Problems
Answered by Dr. V. Sasanka 25 hours later
Brief Answer:
Please get a urine examination and USG scan

Detailed Answer:
You have given a fairly good account of your symptoms and what you have done immediately following this should be appreciated.
I recollect at least two occasions in the past two years when patients have said that they have noticed particles coming in their urine which was a part of their diet - this was a result of an abnormal communication between the rectum and the urinary bladder; this was due to constipation complicating a condition called diverticulosis of the colon and eventually once the diverticular segment of colon was surgically excised and constipation was cured, the patients had no such problems.
In your case too, if there indeed is a living worm that has come out of your urinary tract, I feel there might be an issue with the colon / rectum, and this should not be ignored.
What I can suggest at this point of time is that you get at least an ultrasound examination and a complete urine examination done to see if there are any features such as pus cells and red blood cells in urine suggestive of active inflammation and any thickening of the bladder wall to indicate abnormal pathology. Depending on clinical examination and reports of investigations, we can proceed further with other investigations such as colonoscopy, enema, CT scan, etc.
The chances of a worm originating in the urinary tract is very remote.
Hope I have been able to help you.
Above answer was peer-reviewed by
Follow-up: Noticed small, whitish/ translucent, worm-like thing after urination. No pain. What can this be? 26 minutes later
Thank you for your response. So you don't believe it could be a schistosome or some other water-borne parasite? I forgot to mention that I live in Thailand, and the water here isn't great. Tap isn't drinkable. But I know parasites like schistosomes typically aren't ingested, and that they usually get in through the skin after people go into water. Outside of one hot bath I took a few weeks ago, I haven't submerged myself in anything but our swimming pool. Also, the images I found of schistosomes online (I promise I'll consider your advice over Internet self-diagnosis!) looked similar to what I saw a couple nights ago, though I couldn't see this thing in clear detail.

There's still the possibility that it was already in the bowl, but it just didn't appear to be something you see in everyday life....
Answered by Dr. V. Sasanka 12 minutes later
Brief Answer:
It was already in the bowl - sounds best bet

Detailed Answer:
As a matter of fact, I did consider Schistosomiasis which does affect the bladder, but I do not recollect ever having heard anyone say they pass the worms in the urine. (I must admit my experience or most Asian Urologists in this matter is likely to be pretty low, unlike ,say, the Egyptian Urologists who see this condition a lot more).The condition does cause fairly florid bladder issues, in the sense sufferers actually mention that they need to visit the toilet frequently, and at night are frequently disturbed by urge to void. In the absence of above symptoms in your case, it would be difficult to imagine a live worm coming out. either way, should there be a bladder infestation, it is quite likely that the urine examination will show pus cells or blood cells.
There is also a possibility that the worm was there in the toilet bowl after a previous bowel movement in which case the plausibility levels go higher. there is a worm (which is endemic in nations with poor water sanitation facilities like India, Thailand) known as Round Worm or Ascaris Lumbricoides the description of which is similar to what you noted. If it is so, then you can probably take a course of anti-worm medicine and you should be fine very soon.
You are welcome to revert with any questions to what looks like a fairly interesting discussion.
Best wishes.
Above answer was peer-reviewed by
Follow-up: Noticed small, whitish/ translucent, worm-like thing after urination. No pain. What can this be? 15 minutes later
Thanks -- you've given a lot of thought to this. From what I've read, symptoms of schistosomiasis ("florid" issues -- love that term) present themselves before one would start seeing full-grown flukes, if at all, because the body responds against the eggs, not the adults. And I've had no symptoms whatsoever.

So, I'm thinking you're right -- it was in the bowl. I'll check with a pharmacist or local clinic to get a course of medication and see where that takes me. I might also recommend that the other two members of my family do the same, just in case it wasn't me!
Answered by Dr. V. Sasanka 51 minutes later
Brief Answer:
Albendazole might work

Detailed Answer:
There is a medication which usually does the job in a single dose. It is Albendazole and in fact we do dose families with it if one member is affected but I imagine you should consult a doctor for the prescription before it is made available to you by a chemist.
Also, for whatever it is worth, I suggest you do get a urine examination and if required, an ultrasound examination of abdomen.
Please let me know if anything turns up or if you have any query.
Above answer was peer-reviewed by
Follow-up: Noticed small, whitish/ translucent, worm-like thing after urination. No pain. What can this be? 5 minutes later
Great, will do. Thank you Dr. Sasanka!
Answered by Dr. V. Sasanka 12 days later
Brief Answer:
You are welcome

Detailed Answer:
Good luck
Above answer was peer-reviewed by
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