Brief Answer:
You need to repeat urinalysis with microscopy to confirm findings

Detailed Answer:
Hello,
Thank you for asking at HCM.

I carefully read your question and understand your concern.

Non-hem blood in urinalysis is a common finding that needs to be confirmed by microscopy. The strips used for urinalysis have high sensitivity so they might come out positive in many patients but they have low specificity so if it is positive it does not necessarily mean you have blood in urine.

To make it easier, it means: if there is no blood found in the test it is for sure you do not have blood but if blood is detected than you need to confirm it with microscopy as many of those results are false positive.

Another reason that the test might show blood but is not blood is the finding of non-hem blood which means it finds presence of "hem" which is part of the hemoglobin of the blood cells but also is part of myoglobin that is a muscular cell so if you have been using your muscles a lot before the test or you are dehydrated non-hem blood can come out positive but it might be due to muscular cells and not blood presence in urine.

I do not see in your question the reason why you did the urinalysis. Did you have urinary symptoms or your urine was darker?

I would say that you need to do a urinalysis with microscopy and confirm if there is blood present or not. If blood is present than the next step is to repeat the urinalysis in 2 weeks and see if it is a consistent finding.

If repeat urinalysis shows blood the next step is to find why there is blood in urine.

Sometimes kidney stones might cause some blood in urine and ultrasound can see the stones in only 20% of the cases.

If you are having your periods and the urine test is done close to your periods you might have the blood in urine due to that.

Kidney tumors and urinary bladder tumors might be a cause of blood in urine but they are less likely and those above mentioned causes are more likely.

So to conclude:

1. do a urinalysis with microscopy
2. If red blood cells present then repeat it in 10 days or 2 weeks (you should not be close to periods or right after them)

3. If red blood cells seen in repeat urinalysis than you will need tests like an abdominal ultrasound (can see stones in 20% of cases and tumors), X-ray of the abdomen (can see stones in 80% of the cases)

4. Doing a urine culture sensitivity might be helpful also and if it is negative it is for sure you do not have a urinary infection.

5. if still not able to find the cause of blood in urine than cystoscopy and pyelography and sometimes CT scan are considered- these are more specific tests for examination of urinary system.

I hope this is helpful and answers to your question

Kind Regards,

Dr Antoneta Zotaj

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