Should You Get Further Tests for Hematuria and WBC in Urine? - Urology

More Info

---

When it comes to the presence of hematuria (blood in urine) and elevated white blood cells (WBC) in urine, it is essential to understand the implications of these findings and whether further testing is warranted. Hematuria can be classified into two types: gross hematuria, which is visible to the naked eye, and microscopic hematuria, which is only detectable through laboratory testing. The presence of WBCs in urine typically indicates some form of inflammation or infection within the urinary tract.

Given your history of hematuria and elevated WBCs over the past four to five years, it is understandable that you are concerned, especially considering your son's medical history with a left-sided ureteral anomaly. While your urologist may have deemed the absence of symptoms like burning during urination or flank pain as indicators that there is no urinary tract issue, it is crucial to remember that some conditions can be asymptomatic, particularly in their early stages.

The fact that you have been experiencing persistent microscopic hematuria and elevated WBCs warrants further investigation. Although your previous evaluations did not reveal any bacterial infection, the presence of WBCs could suggest a non-bacterial inflammatory process or even a potential malignancy, such as bladder cancer, especially given your concern about ruling out serious conditions.

Here are some recommendations for further evaluation:
1. Repeat Urinalysis: A repeat urinalysis can help confirm the presence of hematuria and WBCs. It is essential to collect a midstream urine sample to minimize contamination.

2. Urine Culture: Although you mentioned that a previous culture did not yield any bacteria, it may be worth repeating this test, especially if you have had any changes in symptoms or urinary habits.

3. Imaging Studies: Given your history and the presence of hematuria, imaging studies such as a renal ultrasound or a CT scan of the abdomen and pelvis may be beneficial. These tests can help visualize the kidneys, ureters, and bladder for any structural abnormalities, stones, or masses.

4. Cystoscopy: If hematuria persists, a cystoscopy may be warranted. This procedure allows a urologist to directly visualize the bladder and urethra, which can help identify any lesions or abnormalities that may not be apparent on imaging studies.

5. Consultation with a Specialist: If you have not already done so, consider seeking a second opinion from a urologist, particularly one who specializes in hematuria. They may have additional insights or recommendations based on your specific case.

6. Monitoring: Regular follow-up with urinalysis and clinical evaluation is essential. If there are any changes in your urinary symptoms or if new symptoms arise, it is crucial to seek medical attention promptly.

In conclusion, while your previous evaluations may not have indicated a significant issue, the persistence of hematuria and elevated WBCs should not be overlooked. Further testing is warranted to rule out any underlying conditions, including potential malignancies. It is always better to err on the side of caution when it comes to your health. Please discuss these options with your healthcare provider to determine the best course of action for your situation.