Question: Hello- my primary care and urologist have mixed opinions. Primary suspects bladder stones, urologist small kidney stones. About four months ago I had some burning urine, passed some time black specks. Also may have passed two times a large mass of what looked like small pieces of clear tissue paper- large and small, squarish, translucent pieces only noticeable because they cast shadows as they sank. Some as large as half an inch, in ragged square shape, very thin. Honestly just assumed it was odd but likely some tp in bowl- couldn't imagine urinsting things that large out and not feeling it! All my urine tests were clear, only occurred for a few days, I was in no more pain, my doc said you passed stones don't worry. Felt great for about three months after that.

About a month ago I started having significant burning in penis after urinating- was dehydrated for about a week, should have consumed more water! Was given 30 days of doxycycline by primary. All urines - I've had four in the last month- completely normal. I passed out a few small black particles several times over last few weeks and pain still present but significantly better. Urologist did ultrasound of kidneys, CAT scan, no contrast, of kidneys and bladder- all appeared normal. The stones have been too small to test. Then over weekend twice I may have urinated out the toilet paper thingees again. Oddly all my urines before and after are crystal clear. But there are a lot of particles- they are very delicate, break apart extremely easily when caught, and mix of sinkers (the big ones) or stay suspended (tiny dots). Consistency somewhat slimy but not at all sticky, break apart if touched. Pretty much invisible unless light on them. To be fair- both toilets were quite dirty when this happened, if it wasn't fourth time Id think maybe it was slime mild or bacteria sheet. My regular doc suspects just toilet junk; urologist looked at what I caught, has no idea what is, too contaminated to test, giving me a cystoscopy next week just to be safe. I have only occasional minor soreness in back/flanks- I lift weights it just feels like minor muscle strain. No blood whatsoever. I do suffer from chronic prostatis/pelvic pain disorder too- on rapaflow which helps. My main concern is those tp like shreds- is it even possible to pass something like that? What could they be if so? Thank you- XXXXXXX

No culture testing was done of any fluids other than general screen of urine for generalized signs of infection. The prostatis was dx three years ago- on and off pain at tip of penis, worse with urination; given courses of cipro then Bacttim; bactrim helped most but symotoms still cycle. PSA slightly raised; digital exams normal, not sensituve to touch; all urines normal; cytoscope normal three years ago, as was kidney ultrasound

Thank you! Will review this with my docs. Definitely keeping flushed with water (mixed with citrus). Have a cystoscopy set up next week- that should detect any bladder inflammation?

Thank you! Wish you practiced in XXXXXXX Maryland USA!