Painless Hematuria in Patients with Kidney Stones

Q: Painless Hematuria in Patients with Kidney Stones

Hello： It is true that a history of kidney stones can lead to hematuria; however, if there is painless hematuria and the individual is over 40 years old, I personally recommend a thorough examination. <br>An Intravenous Pyelogram (IVP) and detailed X-rays are among the necessary

History of kidney stones with painless hematuria?

Hello doctor, I have a history of kidney stones from five years ago and two years ago.
The initial kidney stones caused severe pain, and I underwent lithotripsy.
Recently, within the past month, I experienced sudden hematuria, which is visible to the naked eye but not bright red.
There is no pain in the urinary tract, only slight discomfort in my lower back and the upper left groin area.
After undergoing an IVP (with normal kidney function) and X-rays, three stones smaller than 0.25 cm were found.
After taking Buscopan and increasing my water intake, the hematuria was almost resolved.
However, about half a month later, the same condition reappeared—painless hematuria.
Again, after taking Buscopan and drinking more water, there was improvement, but the symptoms returned after a while.
I would like to know if the stones are being expelled or if further examinations are necessary.
Does regular exercise help in passing the stones? Thank you.

Yo, 20~29 year old female. Ask Date: 2019/06/09

Dr. Du Shixi reply Urology

Hello: It is true that a history of kidney stones can lead to hematuria; however, if there is painless hematuria and the individual is over 40 years old, I personally recommend a thorough examination.
An Intravenous Pyelogram (IVP) and detailed X-rays are among the necessary tests.
Closely monitoring your urine is something you can do at this time.
Wishing you good health.

Reply Date: 2019/06/09

More Info

Painless hematuria, or blood in the urine without accompanying pain, can be concerning, especially in patients with a history of kidney stones. In your case, the presence of blood in the urine, particularly after a history of significant kidney stone pain, warrants careful evaluation.
Given your history of kidney stones and the recent imaging studies (IVP and X-ray) that revealed small stones, it is plausible that the painless hematuria you are experiencing could be related to the stones. Small stones, particularly those less than 0.5 cm, can sometimes irritate the urinary tract lining as they pass through, leading to bleeding. However, the absence of pain is atypical, as kidney stones usually cause significant discomfort when they obstruct the urinary tract or irritate the lining.

The fact that you have experienced intermittent episodes of painless hematuria suggests that there may be an ongoing issue with the stones or the urinary tract. The use of medications like Buscopan, which is an antispasmodic, can help alleviate discomfort and may assist in the passage of stones by relaxing the muscles of the urinary tract. Drinking plenty of fluids is also crucial, as it helps to dilute the urine and can promote the passage of stones.

However, since the hematuria has recurred, it is advisable to follow up with your healthcare provider for further evaluation. Additional imaging studies, such as a CT scan, may be warranted to assess the current status of the stones and to rule out any other potential causes of the hematuria. It is also important to monitor your urine for any changes in color or consistency and to report any new symptoms, such as pain or changes in urination.

Regarding your question about exercise, regular physical activity can indeed help in the management of kidney stones. Exercise promotes overall health and can aid in maintaining a healthy weight, which is beneficial since obesity is a risk factor for stone formation. However, it is essential to stay well-hydrated, especially during exercise, to help flush out the urinary system.

In summary, while your symptoms may be related to the passage of kidney stones, the recurrence of painless hematuria necessitates further investigation to ensure there are no underlying complications or additional issues. Regular follow-ups with your healthcare provider, maintaining hydration, and monitoring your symptoms are key steps in managing your condition. If you experience any new or worsening symptoms, do not hesitate to seek medical attention promptly.

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