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    What causes hematuria in a diabetic?

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Posted on Mon, 7 Aug 2017 in Urinary and Bladder Problems
Question: I'm a 52 year old white male. Two years ago I was diagnosed with type 2 diabetes mellitus. This past February I was urinating more than I thought I should be and went into the Doctor. They did a urinalysis and found microscopic hematuria in my urine and sent me to a urologist. They did a rectal exam, PSA, cystoscopy, and a CT of my abdomen and pelvis area with and without contrast. They said everything can back fine. But I have these lingering doubts. They tell me if worried about nothing that I am fine. They put me on effexor to treat somatic symptoms disorder. First question is would the CTcover all my organs? Second questions should I trust their answer? zthird question, I've been on this effexor xr 37.5mg for 4 months. Could it still be making me tired? Should I just get on with my life and trust all of this?
doctor
Answered by Dr. Panagiotis Zografakis 1 hour later
Brief Answer:
the urologic evaluation is probably complete...

Detailed Answer:
Hello,

regarding your hematuria. You've done a CT scan which is the best modality to diagnose renal cancer and you've done a cystoscopy which is the best test for bladder cancer. The rectal exam and the PSA may detect prostate cancer. So you've done a pretty good urological "check-up". If you've also done urine cytology (3 samples are better than one) and it's negative then you can't do anything more than that.

The answer to your second question is essentially the same. They've checked your urinary system thoroughly, so their answer has to be trusted. If no adequate answer has been given then perhaps follow-up testing after a couple of months of so may be appropriate.

Finally, regarding your third question... effexor may indeed cause fatigue. Some patients don't have fatigue or get used to the side effect and get on well with the drug. If this side effect is very annoying for you then you should talk with your doctor. The doctor should determine whether it's a side effect or the psychological disorder itself that makes you feel this way. If it's the drug then perhaps an alternative regimen should be tried.

I hope it helps!
Kind Regards!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Panagiotis Zografakis 16 minutes later
now the CT scan would show all the other organs in the abdomen and pelvic area too right?
doctor
Answered by Dr. Panagiotis Zografakis 5 minutes later
Brief Answer:
yes but...

Detailed Answer:
The CT scan of the urinary system is done differently than a CT scan for the upper abdomen (liver, pancreas, etc). Although certain findings may still be visible we wouldn't rely (to exclude a diagnosis) on a CT scan that was ordered for other organs. It has to do with the contrast media and the way it's administered depending on the target organ. I suppose the urologist ordered a scan of the urinary tract. This is different from the scan that's done for the liver and the rest of the abdominal organs. It doesn't matter much though because we wouldn't expect anything from the rest of the organs if the urinary tract was OK.

Kind Regards!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Panagiotis Zografakis 12 minutes later
Ok thanks
doctor
Answered by Dr. Panagiotis Zografakis 3 minutes later
Brief Answer:
You're welcome

Detailed Answer:
Glad to help!
Above answer was peer-reviewed by : Dr. Remy Koshy
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Answered by
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Dr. Panagiotis Zografakis

Internal Medicine Specialist

Practicing since :1999

Answered : 3691 Questions

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