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Having Systemic Lupus. Ultra Sound Of Kidney Shows Microhematuria. Should I Get The X-ray Done?
Hello. I have systemic lupus (calm). I usually get lab work done 1-2 times a yr. to check my kidney, etc. due to the lupus. Three yrs. ago, June 2010 I've been having occult blood (1) in my urine. I asked my Rheumatalogist and she said I probably took the urine test close to my period or near the end of my period and that's why it showed the occult blood, so I didn't worry anymore. This July I had my lab work done and again the occult blood (1) showed up (as it has been in the last 3 yrs.). This time however my Rheumatologist was concerned and told me to see a urologist. Because I couldn't see a urologist sooner, I went to see my family doctor. He ordered a urine test and an ultra sound of the kidney. He diagnosed me as microhematuria. When I finally saw the urologist, she ordered a urine cytology and rec'd that I get a cystoscopy esp. because my lab showed occult blood (1) along with rbc 4-10 . She wanted to make sure that I don't have a bladder cancer or kidney disease so a cystoscopy needed to be done. When I did the urine test that day, I believe the cup was contaminated that's why it showed the rbc 4-10. When repeated, it didn't show rbc 4-10, but normal rbc 0-2 (below)
Results:
1. Urine--- no infection, occult blood (1), rbc 0-2
2. Ultra Sound of Kidney--- 3 x 5 mm nonobstructing stone in the inferior pole of right kidney
3. Urine cytology--- benign
I recently talked to a 2nd urologist at a social gathering and he told me that I should get an x-ray, kub to see accurately the size of the kidney stones, etc. He actually rec'd a ct scan but changed his mind when I told him that I was trying to get pregnant. So with that info., he rec'd me to get an x-ray instead. He also rec's that I get rid the stones asap even though I have no pain because if I get pregnant it would be bad.
QUESTIONS:
1. Should I get the x-ray done when the ultra sound already shows the amt. and size of the stones? I would think the ultra sound and x-ray both show the same size and amt. of stones even though they are two different tests.
2. Should I still get the cystoscopy even though I have benign in urine cytology and that I have occult blood due to kidney stone (from ultra sound) ?
3. Should I get rid of the stones since I'm trying to get pregnant even though I have no pain?
4. The 2nd urologist rec'd I get lithotripsy done soon before I get pregnant even though I'm not in pain. Is this the correct or rec'd procedure?
Thanks.
Results:
1. Urine--- no infection, occult blood (1), rbc 0-2
2. Ultra Sound of Kidney--- 3 x 5 mm nonobstructing stone in the inferior pole of right kidney
3. Urine cytology--- benign
I recently talked to a 2nd urologist at a social gathering and he told me that I should get an x-ray, kub to see accurately the size of the kidney stones, etc. He actually rec'd a ct scan but changed his mind when I told him that I was trying to get pregnant. So with that info., he rec'd me to get an x-ray instead. He also rec's that I get rid the stones asap even though I have no pain because if I get pregnant it would be bad.
QUESTIONS:
1. Should I get the x-ray done when the ultra sound already shows the amt. and size of the stones? I would think the ultra sound and x-ray both show the same size and amt. of stones even though they are two different tests.
2. Should I still get the cystoscopy even though I have benign in urine cytology and that I have occult blood due to kidney stone (from ultra sound) ?
3. Should I get rid of the stones since I'm trying to get pregnant even though I have no pain?
4. The 2nd urologist rec'd I get lithotripsy done soon before I get pregnant even though I'm not in pain. Is this the correct or rec'd procedure?
Thanks.
Sat, 16 Nov 2013
Hi there, sle can affect kidney best way to detect is RBC in urine examination> 4, urine spot protein creatinine ratio > 0.2 and high dsdna and low c3 levels . Then we call it lupus nephritis. In your case stone is also present. So rbc can be because of stone also. It is important to rule out SLE nephritis as it is more dangerous.
Xray msy not be helpful. If you wantvimaging study to document stone size and number then ct kub plain should be done. It has no effect on future pregnancy. If the stone is a single stone of 3 to 5 mm as in the ultrasound. There is no need of anyvtreatment before pregnancy. If a problem arises it can be tackled as such chances are very less as it is a very small stone. Chancesvof cancer are only there if your age is greater than 50 yr in that case also ct should be done before cystoscopy. And most likely cystoscopy will not be needed.
Best wishes.
Xray msy not be helpful. If you wantvimaging study to document stone size and number then ct kub plain should be done. It has no effect on future pregnancy. If the stone is a single stone of 3 to 5 mm as in the ultrasound. There is no need of anyvtreatment before pregnancy. If a problem arises it can be tackled as such chances are very less as it is a very small stone. Chancesvof cancer are only there if your age is greater than 50 yr in that case also ct should be done before cystoscopy. And most likely cystoscopy will not be needed.
Best wishes.
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