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Urine in blood, had kidney ultrasound, CAT scan,transvaginal ultrasound, all normal. Urine reoccurred. Unable to determine cause ?

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back in late August, i had some unexplained blood in my urine. The urine test did not show any infection so my doctor sent me for a kidney ultrasound which indicated a possible enlarged rt. kidney. I was referred to a urologist who called for a CAT scan, his urine analysis showed no blood and the cytology test was fine. The CAT scan came back fine and indicated that the cat scan showed no reason for blood in my urine. In addition, during that same time, my dr wanted me to make sure it wasn't gyno related. My gyno did an exam - fine, urine test-fine and transvaginal ultrasound - fine. She felt comfortable that it was not gyno related (plus, I never spotted). My blood only lasted for 1 day about 8 hours. After all these tests, and all the additional urine tests showing no blood, my dr. was willing to chalk it up to one of those things unless it happened again. Unfortunately, the blood in my urine started last night (this is about 3 mos from the last episode) so she wants me to goo back to the urologist who wanted to do a cysto if the blood returned. The blood only lasted one day and, similar to last time, seems to taper off Anyway, I'm figuring it might take a week or 2 to get a new patient appointment so was wondering if you could advise as to possible aliments -- especially cancer or can I rule that out mostly due to the CAT
ALso, my CAT scan did show possible gallstones but followed up with a GI dr. who didn't think is was an issue but was concerned about my continuing bad acid reflux -- he put me on nexium for 3 months (on it for 1 month so far) and is doing an endoscope on 11/29 to check for inflammation and some biopsies.
Posted Sat, 28 Apr 2012 in Urinary and Bladder Problems
Answered by Dr. Rajiv goel 17 hours later

Thanks for the query.

Recurrent appearance of blood in the urine certainly needs thorough evaluation till the reason for it is proven benign. You should see urologist for cystoscopic examination. Since a large number of small lesions can be missed on CAT scan, cystoscopy is mandatory.

With respect to your primary concern, I can be able to assist you further upon receipt of cystoscopy report.

If your question is about cancer, we should check for risk factor associated with urinary tract cancers such as Cigarette smoking. This greatly raises the suspicion of cancer. If you were not a smoker or do not smoke, please do not worry about cancer till confirmation.

Continued acid reflux is again probably a function of gall stone disease. There are better treatment options available if it is bothering your day to day activities. Consider speaking to the Gastroenterologist for removal of Gall bladder.

Hope this helps. Should you have any additional concerns, with respect to my recommendation, I am available to follow up.

Above answer was peer-reviewed by
Follow-up: Urine in blood, had kidney ultrasound, CAT scan,transvaginal ultrasound, all normal. Urine reoccurred. Unable to determine cause ? 29 hours later
I am 46 year old non-smoker woman -- just curious, if I got a clean cat scan of my abdominal and pelvic region, can that generally rule out most of the urological cancers -- for example, kidney, uterer etc.

Also, with typical bladder cancer, does bleeding start and then go away over a period of time or usually stays in the urine even if it is microscopic. Would a CAT scan see bladder cancer or just a cystoscope?

Answered by Dr. Rajiv goel 12 hours later

CAT (Computerized Tomography) scan usually picks up large lesions but small lesions will be missed and cystoscopy is mandatory in such case.

Bleeding pattern can be highly erratic in Carcinoma bladder and one may be asymptomatic for months together.

Hope I have answered your query.

Above answer was peer-reviewed by
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