Hematuria: When and How to Accurately Test Urine

Hematuria examination

Urinalysis revealed hematuria, but aside from edema in the legs, there are no other discomforts.
Ultrasound and X-ray examinations showed no abnormalities.
This could potentially be due to urethritis or ovulatory bleeding (which has been confirmed to occur).
The doctor advised me to drink more water and to return for testing on the sixth or seventh day of my next menstrual cycle.

During the hot summer, I have to spend all day in a high-temperature and humid environment, which can be uncomfortable with sanitary pads.
After menstruation, I often experience itching, pain, and heat discomfort in the genital area, which has delayed my follow-up visit to the hospital for over two months.

1.
Given that I have uterine fibroids and my menstrual periods last seven to eight days, along with ovulatory bleeding, what are the accurate days for urinalysis? Besides the time after menstruation, are there other suitable times for urinalysis? (I want to avoid unnecessary waste of medical resources for cystoscopy due to false results.)
2.
Do the symptoms of discomfort, pain, heat, and itching in the genital area affect the results of the urinalysis?

Han, 40~49 year old female. Ask Date: 2018/08/10

Dr. Xu Wencang reply Urology

If there is mild hematuria and subsequent tests show no abnormalities, monitoring can continue.
Urine tests should be conducted outside of the menstrual cycle and any vaginal or uterine bleeding, and a midstream urine sample should be collected.

Reply Date: 2018/08/10

More Info

When it comes to accurately testing for hematuria (the presence of blood in urine), timing and technique are crucial. Hematuria can be a symptom of various underlying conditions, and understanding when to conduct urine tests can help avoid misdiagnosis and unnecessary procedures.

1. Optimal Timing for Urine Testing
Given your situation, where you have a history of uterine fibroids and experience prolonged menstrual bleeding, it is essential to choose the right time for urine testing. The best time to collect urine samples for testing is when you are not menstruating or experiencing any vaginal bleeding. This is because menstrual blood can contaminate the urine sample, leading to false positives for hematuria.

The ideal time for urine testing is typically:
- Mid-Cycle: This is usually around 7-14 days after the first day of your last menstrual period, depending on your cycle length. During this time, you are less likely to have any bleeding that could interfere with the results.

- Post-Menstrual Phase: Waiting a few days after your menstrual period ends can also be a good option. This allows any residual menstrual blood to clear from your system.

In your case, since your doctor suggested testing around the 6th or 7th day of your next menstrual cycle, this could be a suitable time as it is likely to be free from menstrual contamination. However, if you experience ovulation bleeding, which can occur around the middle of your cycle, it’s best to avoid testing during that time as well.

2. Impact of Vaginal Discomfort on Urine Testing
Regarding your concerns about vaginal discomfort, itching, and pain, these symptoms can potentially affect urine test results. If there is any inflammation or infection in the vaginal area, it could lead to the presence of white blood cells or bacteria in the urine, which may complicate the interpretation of hematuria.
To minimize the risk of contamination and ensure accurate results, consider the following:
- Hygiene: Maintain proper hygiene before collecting the urine sample. Clean the genital area thoroughly to reduce the risk of contamination.

- Midstream Collection: Use the midstream method for urine collection. This involves discarding the first part of the urine stream and collecting the middle portion, which is less likely to be contaminated by vaginal secretions.

- Avoid Testing During Symptoms: If you are experiencing significant discomfort or symptoms of infection, it may be wise to postpone the urine test until these symptoms have resolved.

Conclusion
In summary, for accurate urine testing for hematuria, aim to collect samples during the mid-cycle or shortly after your menstrual period, avoiding times of bleeding or discomfort. If you have ongoing symptoms or concerns, it is crucial to communicate these with your healthcare provider, as they may suggest further evaluations or alternative testing methods to ensure a comprehensive assessment of your urinary health. Always prioritize your health and seek medical advice when in doubt, especially when symptoms persist or worsen.

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