Sudden Back Pain and Blood in Urine: A Urology Perspective

Q: Sudden Back Pain and Blood in Urine: A Urology Perspective

Hello： Some small stones may only present symptoms initially, and subsequent examinations may not confirm the diagnosis. <br>However, the doctor prescribed medication, which includes a relaxant (to facilitate stone passage), pain relief (as some stones can cause pain during passa

Low back pain with hematuria and no abnormalities?

Hello, Chief Physician.
A few nights ago, I suddenly experienced lower back pain, which was a sharp pain right in the middle, without any deviation to the left or right.
A few hours later, when I went to urinate, I noticed a significant amount of bright red blood in my urine, but subsequent urination was normal.
The next morning, I visited a urologist.
After examination, the doctor indicated that the X-ray showed no kidney stones, and the urinalysis showed no abnormalities in the blood.
An ultrasound of my lower back also showed no issues.
The doctor suggested that it might have been caused by a small stone passing, which led to the hematuria, but during the X-ray, they said there were no stones.
Is this possible? Later, I was prescribed three medications: E74 Hyoscine (scopolamine) butylbromide, 273 Acetaminophen [scanol], and 271 [MgO] Magnesium oxide.
What are the effects of these medications, and do I need to take them? I apologize for the lengthy message, and thank you, Dr.
Du.

Hong, 20~29 year old female. Ask Date: 2016/12/16

Dr. Du Shixi reply Urology

Hello: Some small stones may only present symptoms initially, and subsequent examinations may not confirm the diagnosis.
However, the doctor prescribed medication, which includes a relaxant (to facilitate stone passage), pain relief (as some stones can cause pain during passage), and a digestive aid (since some stone patients may experience gastrointestinal symptoms).
As it is currently uncertain whether the stones have been expelled (some stones are very small and may not cause significant symptoms after the initial presentation), if you have no symptoms at all, you may not need to take medication.
However, it is essential to drink plenty of water (at least 2500-3000 cc of plain water).
Additionally, if you continue to experience mild symptoms or if symptoms recur, you will need to take the medication regularly and return for a follow-up appointment once the medication is finished.

Reply Date: 2016/12/16

More Info

Hello! Thank you for your detailed question regarding your recent experience with sudden back pain and blood in your urine. It sounds like you've been through quite a bit, and I appreciate your thoroughness in describing your symptoms and the medical evaluations you've undergone.

From your description, it seems that you experienced acute back pain followed by hematuria (blood in urine). The fact that the blood was noticeable but then resolved quickly could suggest a transient issue, possibly related to a small stone or some irritation in the urinary tract. It's important to note that even if X-rays did not show any stones, they can sometimes be missed, especially if the stones are small or composed of materials that are not radiopaque (not visible on X-ray). Additionally, stones can pass through the urinary tract without being detected on imaging, leading to temporary bleeding.

Regarding the medications prescribed to you:
1. Hyoscine (Scopolamine) Butylbromide (E74): This medication is an antispasmodic that helps relieve muscle spasms in the gastrointestinal tract and urinary system. It can be beneficial if your back pain is related to spasms in the muscles around the urinary tract or bladder.

2. Acetaminophen (273): This is a common pain reliever and fever reducer. It can help alleviate any discomfort you may be experiencing from the back pain or any residual pain from the hematuria.

3. Magnesium Oxide (271): This supplement can serve multiple purposes, including acting as a laxative or helping to prevent kidney stones by maintaining a proper balance of minerals in the body. It may also help with muscle relaxation.

As for whether you need to take these medications, it largely depends on your current symptoms. If you are still experiencing pain or discomfort, it would be advisable to take the medications as prescribed. However, if you feel fine and the symptoms have resolved, you might not need to continue them. Always consult your physician before making any changes to your medication regimen.

In terms of follow-up care, it is crucial to monitor your symptoms. If you experience recurrent hematuria, persistent back pain, or any new symptoms such as fever, chills, or changes in urination patterns, you should seek medical attention promptly. These could be signs of a urinary tract infection (UTI) or other complications that may require further investigation.

Additionally, staying well-hydrated is essential, as it can help flush out any potential irritants in the urinary tract and may prevent the formation of new stones. If you have a history of kidney stones, discussing dietary changes with your healthcare provider may also be beneficial to prevent future occurrences.

In summary, while your symptoms may have resolved for now, it is important to remain vigilant and maintain communication with your healthcare provider. If you have any lingering concerns or if your symptoms return, do not hesitate to seek further evaluation. Your health is paramount, and understanding the underlying causes of your symptoms will help ensure you receive the appropriate care. Thank you for your question, and I hope you find relief soon!

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