Brief Answer:
Multiple causes are still there needed to be ruled out by Urologist !!!

Detailed Answer:
It's Dr. Hanif with a warm welcome. Thanks for visiting and trusting HCM. I have thoroughly reviewed health query you raised, and well realize all of those concerns.

PROBABLE CAUSES:
**. On top of the causes for blood in urine (hematuria) is urinary tract infection. It is the most common sign in elderly people when bacteria enter the bladder through urethra and start to multiply there. You need to ask your Urologist for thorough urine examination testing and to see if there is any chance of urinary infection. Other test to perform is Urine Culture and Sensitivity test to rule out the pathogen causing this hematuria to be there. Although your sister did some kind of urine test but I still suggest to repeat these two tests.


**.Kidney infections. But you have no flank pains and fever so seems to be less likely. Your urologist can see if there is kidney infection causing hematuria.

**.Cancer of kidney, bladder, prostate. This is also a big cause at this age and visible blood in urine in many cases is due to cancer. Your Doctor will have to rule this out too. Spiral CT scan and renal and bladder ultrasound will help find out the cause.

**. Certain blood disorders like sickle cell may cause blood in urine. Hematologic and coagulation investigations will help find out the cause to be blood related.

**.Inflammation of the kidney's system of filtration.

**.Enlarged prostate: It is very common cause in this age group. You need definitely to ask your Urologist to see if there is a chance for enlargement of prostate.

**.Bladder and/or kidney stones also cause blood in urine and needs evaluation. Your Urologist will have to go for Ultrasound/X Ray kidney,ureter,bladder.

**.Certain medications e.g. antibiotics, analgesics, aspirin, heparin and a lot more can cause blood in urine. Which medications are you on right now (for any reason)?

**.Recent infections of the urinary tract also cause blood in urine and pain so is the case with advancing age and prostate gland enlargement that may cause occasional bleeds and pain.

MANAGEMENT OPTIONS:
Definitive management goes according to the cause as we need to remove the cause of the issue first. Blood in urine and pain in penis is not itself a disease actually. Rather it is manifestation of some underlying disease.
Please keep a judicious supply of clean drinking water. If you feel difficulty voiding urine or have a narrow stream/flow of urine, then consult your Urologist before taking extra fluids as this can be due to prostate gland enlargement.
Take Cranberry juice for alleviating the symptoms of disease you have.
Proper rest is needed for faster recovery. Avoid strenuous activity, hot and humid enviroment.

FINAL SUGGESTIONS:
Please spare some time to consult a Nephrologist/Urologist for considering the above mentioned probabilities. You did visit a Urologist before I know. If not satisfied, you can think of changing your Urologist too. But important is to discuss with him all the options as aforementioned.

Hope I addressed all the concerns you have. Let me know if you have further questions. I will be more than happy to help. In future for a fast and direct consultation from me use this link ( http://tinyurl.com/drhanifmd ) and I will be with you in no time to solve your health issues.

Regards!

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