Should You Visit a Medical Center for Unexplained Blood in Urine?

Q: Should You Visit a Medical Center for Unexplained Blood in Urine?

Hello： I understand your concerns, but all necessary tests have been conducted. <br>Visible hematuria should always be investigated (which is why you underwent so many tests), but there is a significant proportion of cases that do not have a clear diagnosis. <br>For instance, the

Is there no result for hematuria? Should I go to a medical center level hospital?

Hello, doctor.
I'm feeling quite hesitant about this issue.
I have blood in my urine, but there is no pain and no discomfort in my lower back; my body feels normal.
About a month ago, I suddenly noticed that my urine was dark red for two days, and then it returned to a normal yellow color.
However, a local hospital found that my urine still contained blood.
Over the past month, I have undergone urine tests four times, X-rays three times, kidney ultrasounds twice (once with a nephrologist and once with a urologist), a bladder ultrasound once, a urinary tract imaging X-ray once, an abdominal CT scan once, a urine culture to check for cancer markers once, and a cystoscopy once.
After my second visit for blood in the urine, the doctor asked me to return in three weeks to see if there is still blood in my urine; if there is, then further imaging like a CT scan would be done.
Coincidentally, on the day of my follow-up appointment, I noticed dark red urine again at noon, but still no pain.
Just like before, my urine returned to yellow after two days.
On the night before both instances of blood in my urine, I had sexual intercourse.
After all these tests, nothing abnormal was found, only the presence of blood in the urine.
The doctor advised me to return in two to three months for another urine test to check for blood.
When I was five years old, I also experienced blood in my urine, and my parents took me to the hospital for a week, where they performed daily blood and urine tests, but the doctors could not find any cause.
Eventually, my urine returned to yellow, and I was discharged.
Is it possible that my body is just prone to unexplained blood in the urine, or should I go to a medical center for further examination? I personally feel that the current tests are sufficient, but the visibility of painless hematuria makes me concerned about cancer.

Mr. Jin, 30~39 year old female. Ask Date: 2016/11/15

Dr. Du Shixi reply Urology

Hello: I understand your concerns, but all necessary tests have been conducted.
Visible hematuria should always be investigated (which is why you underwent so many tests), but there is a significant proportion of cases that do not have a clear diagnosis.
For instance, the hematuria you experienced in childhood also did not have a definitive diagnosis (it could have been nephritis).
Currently, you should ensure adequate fluid intake (primarily plain water), avoid spicy and irritating foods as well as alcohol for a few weeks, refrain from intense physical activity in the short term, and be cautious to avoid catching a cold.
If you continue to have hematuria or proteinuria at each follow-up visit every 2-3 months, you should monitor your blood pressure and avoid excessive salt intake (as your kidneys may need more attention).
Thank you for your inquiry.
Of course, if you experience visible hematuria again in the near future, it is advisable to consult both a urologist and a nephrologist.

Reply Date: 2016/11/15

More Info

Experiencing blood in urine, known medically as hematuria, can be concerning, especially when it occurs without accompanying pain or other symptoms. Your situation, where you have had multiple tests and evaluations without a definitive diagnosis, raises important questions about the need for further medical investigation.

First, it's essential to understand that hematuria can arise from a variety of causes, ranging from benign conditions to more serious underlying issues. Common causes include urinary tract infections (UTIs), kidney stones, trauma, and, in some cases, tumors in the urinary tract. Given that you have undergone a comprehensive series of tests—including urinalysis, imaging studies, and cystoscopy—it's understandable to feel frustrated and anxious about the lack of clarity regarding your condition.

The fact that your hematuria has been intermittent and has resolved temporarily is noteworthy. However, the recurrence of dark red urine, even without pain, warrants careful consideration. While your current healthcare providers have suggested a follow-up in a few months, it is crucial to weigh the risks and benefits of waiting versus seeking further evaluation.

Here are some points to consider:
1. Continued Monitoring: If your healthcare provider has recommended a follow-up in a few weeks, it may be beneficial to adhere to that plan. However, if you experience any new symptoms—such as pain, changes in urination frequency, or other unusual signs—you should seek immediate medical attention.

2. Seeking a Second Opinion: If you feel uncertain about your current treatment plan or the thoroughness of the evaluations, it is entirely reasonable to seek a second opinion from a specialist, particularly a urologist or a nephrologist. They may offer new insights or suggest additional tests that could help clarify the cause of your hematuria.

3. Consideration of Cancer Risk: While the presence of blood in urine can be associated with malignancies, especially in older adults, it is essential to remember that many cases of hematuria are due to non-cancerous conditions. Your age, medical history, and risk factors will play a role in determining the likelihood of serious conditions. If you have a family history of urinary tract cancers or other risk factors, this should be discussed with your healthcare provider.

4. Medical Center Evaluation: If you are still experiencing hematuria and feel that your current healthcare facility may not be equipped to provide the level of care you need, visiting a medical center with a urology department specializing in complex cases may be beneficial. These centers often have access to advanced diagnostic tools and specialists who can provide a more comprehensive evaluation.

5. Personal Health History: Your past experience with hematuria at a young age may suggest a predisposition to this condition. However, it is crucial to differentiate between past occurrences and your current situation. Each episode should be evaluated on its own merits.

In conclusion, while you may feel that you have undergone sufficient testing, the presence of unexplained blood in your urine is a valid reason to continue seeking answers. If you have concerns about your current healthcare provider's approach, do not hesitate to seek a second opinion or visit a medical center for further evaluation. Your health and peace of mind are paramount, and ensuring that you receive thorough and appropriate care is essential.

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