Blood in Urine: Kidney Stones and What to Expect

I'm sorry, but I cannot assist with that?

I would like to ask the doctor about my kidney stones (2-3 stones approximately 0.25 cm) that were checked over a month ago.
It seems they haven't passed yet, and I have noticed blood in my urine about once a week.
After drinking water, my urine returns to normal after a day or two, but then blood appears again after about a week.

1.
Is this bleeding due to the stones moving down, or could there be other causes for the hematuria? Two weeks ago, an X-ray showed the stones in the mid-ureter.

2.
Is this occasional hematuria (occurring once every week or two) considered normal? (The color is approximately like this: https://imgur.com/a/FzqV0OV)
3.
How long might it take for the stones to pass? Could it still take another month or two?

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

Dr. Du Shixi reply Urology

Hello; 1) Hematuria in the presence of stones is likely caused by the stones, although other causes are possible but less common.
2) Stones can cause hematuria due to friction; this is not normal and should be considered one of the symptoms.
It is important to drink plenty of water.
3) Some people may pass stones in 2-3 days, while others may take 2-3 months; it varies and there is no specific timeframe for expulsion.
Wishing you good health.

Reply Date: 2019/06/20

More Info

Understanding blood in urine, particularly in the context of kidney stones, can be a complex issue that requires careful consideration of various factors. Based on your description, it seems you are experiencing intermittent hematuria (blood in urine) associated with your known kidney stones. Let's address your questions one by one.

1. Is the blood in urine due to the stones descending, or could there be other causes?
The presence of blood in urine can indeed be attributed to kidney stones, especially if they are moving through the urinary tract. As stones pass through the ureters, they can irritate the lining of the urinary tract, leading to bleeding. This is particularly true if the stones are sharp or if they are causing any obstruction. However, other potential causes of hematuria should not be overlooked. These can include urinary tract infections (UTIs), bladder or kidney infections, trauma, or even tumors. Given that you have had stones previously and they are currently located in the ureter, it is reasonable to suspect that the stones are contributing to the hematuria. However, if the bleeding persists or worsens, further evaluation may be warranted to rule out other causes.

2. Is it normal to have occasional blood in urine (once every couple of weeks)?
Occasional hematuria can be common in individuals with kidney stones, especially if the stones are moving or if there is irritation in the urinary tract. However, while it may be common, it is not necessarily "normal." The fact that you are experiencing this intermittently suggests that there is ongoing irritation or injury to the urinary tract, likely related to the stones. It is important to monitor the situation closely. If the blood becomes more frequent, or if you experience additional symptoms such as pain, fever, or changes in urinary habits, you should seek medical attention promptly.

3. How long might it take for the stones to pass?
The time it takes for kidney stones to pass can vary significantly based on several factors, including the size of the stones, their location, and individual anatomy. Smaller stones (like those around 0.25 cm) often pass more easily and may take anywhere from a few days to a few weeks to pass. However, larger stones or those that are obstructing the urinary tract may take longer and could require medical intervention, such as lithotripsy (shock wave therapy) or ureteroscopy, to facilitate their passage. If you are experiencing persistent symptoms or if the stones do not pass within a reasonable timeframe, it is advisable to follow up with your healthcare provider for further evaluation and management.

In conclusion, while your symptoms may be related to the movement of kidney stones, it is crucial to remain vigilant and consult with your healthcare provider if you have concerns. Regular monitoring and appropriate imaging studies can help ensure that any complications are addressed promptly. Additionally, maintaining adequate hydration and following any dietary recommendations from your healthcare provider can help manage your kidney stone condition and potentially reduce the frequency of hematuria.

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