Urinary Issues: Stones or Low Urine Output?

Q: Urinary Issues: Stones or Low Urine Output?

Hello： 1) If you do not drink enough water, the fluids you consume will be used by your body, and your urine output will definitely be less than the amount of water you intake. <br>If you drink 2000-2500 cc daily, you will only produce 1000-1500 cc of urine. <br>2) Urinalysis for

Kidney stones or low urine output?

Hello, doctor.
Last year, I experienced intermittent frequent urination and a weak urine stream, but since it wasn't a daily occurrence, I didn't pay much attention to it.
Over the past few weeks, I've noticed a strange sensation in my right flank; it's hard to describe whether it's pain or soreness.
Initially, I thought it was due to poor posture.
However, while browsing the internet on Sunday, I came across information suggesting it could be kidney stones, which startled me.
As a result, on Monday, I visited a nearby urology clinic where they performed a urinalysis and found no signs of stones.
They prescribed a three-day course of medication and advised that if my symptoms didn't improve, I would need to go to the hospital for an X-ray.
The medications prescribed were Amoxicillin (250 mg), Phenazopyridine (100 mg), Hyoscyamine, and Indomethacin (25 mg).

I returned home and went to bed around 10 PM.
I likely drank more than 200 cc of water before sleeping, but I woke up around 3 AM.
I didn't feel an urgent need to urinate, just a sensation, yet I only produced about 100 cc of urine, which seemed very little after five hours.
I thought that even if I didn't feel a strong urge, the output shouldn't be that low.
This morning, I drank about 400 cc of water, and again around 10 AM, I didn't feel an urgent need to go, but I had the sensation, and the amount I urinated was only about 200 cc.
Is there a problem with my urination? Could it be renal edema? Should I see a doctor urgently, or should I wait until I finish the three-day course of medication before going back?

Xiao Zhi, 30~39 year old female. Ask Date: 2020/03/17

Dr. Du Shixi reply Urology

Hello: 1) If you do not drink enough water, the fluids you consume will be used by your body, and your urine output will definitely be less than the amount of water you intake.
If you drink 2000-2500 cc daily, you will only produce 1000-1500 cc of urine.
2) Urinalysis for kidney stones often shows trace blood, but since your urinalysis results are normal, there is no need to worry too much.
3) Kidney stones are just one of the causes of lower back pain.
If you continue to experience back pain, it is advisable to see a doctor to identify the cause.
Currently, it is important to drink more water, and if you have any urinary issues, be sure to discuss them with your doctor for further evaluation.
Wishing you good health (If symptoms persist, you should see a doctor).

Reply Date: 2020/03/17

More Info

It sounds like you are experiencing a concerning set of urinary symptoms, including low urine output and discomfort in your right flank. Given your history of urinary issues and the recent changes in your symptoms, it is important to take these signs seriously.

Firstly, the symptoms you describe—intermittent frequency of urination, weak urine flow, and the sensation of discomfort in your right side—could potentially indicate a urinary tract issue, such as a urinary stone or an obstruction. Even though your initial urine test did not show any signs of stones, it is possible for small stones or other issues to be present that may not be detected in a routine urine analysis.

The medications you were prescribed—Amoxicillin (an antibiotic), Phenazopyridine (a urinary analgesic), Hyoscyamine (an antispasmodic), and Indomethacin (an anti-inflammatory)—suggest that your doctor is treating a possible urinary tract infection (UTI) or inflammation. Phenazopyridine is particularly useful for alleviating urinary discomfort, but it does not address the underlying cause if there is an obstruction or stone.

Regarding your urine output, it is indeed concerning that you are experiencing such low volumes, especially after adequate fluid intake. Normal urine output for an adult is typically around 800 to 2000 cc per day, depending on fluid intake, and a significant decrease could indicate a problem with kidney function or urinary obstruction. The sensation of discomfort in your flank could suggest that your kidneys are under stress, possibly due to an obstruction or other underlying issue.

Given these symptoms, it would be prudent to follow up with your healthcare provider sooner rather than later, especially if your symptoms do not improve after completing the course of antibiotics. If you experience any worsening symptoms, such as increased pain, fever, or changes in your urine (such as blood), you should seek medical attention immediately.

In terms of next steps, your doctor may recommend imaging studies, such as an ultrasound or CT scan, to evaluate for any obstructions, stones, or other abnormalities in your urinary tract. These tests can provide valuable information about the condition of your kidneys and urinary system.

Additionally, while you are waiting for your follow-up appointment, continue to stay well-hydrated, as this can help flush out any potential stones or debris. However, if you notice any significant changes in your symptoms, do not hesitate to seek immediate medical attention.

In summary, while it is possible that your symptoms may resolve with the medications prescribed, the combination of low urine output and flank discomfort warrants further investigation. It is always better to err on the side of caution when it comes to urinary health, so please consider reaching out to your healthcare provider for further evaluation.

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