Persistent RBC in Urine: Causes and Concerns - Urology

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Understanding persistent red blood cells (RBCs) in urine can be a complex issue, as there are various potential causes and implications. In your case, the repeated presence of RBCs in urine tests, despite the absence of significant symptoms, raises several considerations.

Firstly, the presence of RBCs in urine, known as hematuria, can be categorized into two types: microscopic hematuria (where RBCs are detected under a microscope) and gross hematuria (where blood is visible to the naked eye). In your situation, it appears that you are dealing with microscopic hematuria, as indicated by the RBC counts in your urine tests.

Several factors could contribute to the persistent presence of RBCs in your urine:
1. Urinary Tract Stones: Given your history of urinary stones, it is plausible that the RBCs are a result of irritation or injury to the urinary tract caused by these stones. Stones can cause microtrauma to the lining of the urinary tract, leading to bleeding. This is especially relevant if the stones are moving or if there are any changes in their size or position.

2. Urinary Tract Infection (UTI): Although you mentioned not experiencing significant symptoms, it is important to note that some individuals may have a UTI without classic symptoms. UTIs can lead to inflammation and bleeding in the urinary tract, resulting in the presence of RBCs.

3. Other Renal or Urinary Conditions: Conditions such as glomerulonephritis, interstitial nephritis, or even tumors in the urinary tract can also lead to hematuria. While these conditions may be less common, they should not be ruled out, especially if the hematuria persists.

4. Medications and Supplements: You mentioned taking a medication called "利石通" (likely a herbal or dietary supplement aimed at treating urinary stones). Some supplements can affect urine composition and may lead to changes in urine appearance or even contribute to hematuria. It is advisable to discuss the potential side effects of any medications or supplements you are taking with your healthcare provider.

5. Hydration Status: Your urine's appearance can vary significantly based on hydration levels. Increased fluid intake can dilute urine and potentially reduce the concentration of RBCs, but it may not eliminate them entirely if there is an underlying issue.

Regarding the floating particles you mentioned, these could be mucus or other debris in the urine, which can sometimes occur due to various reasons, including urinary tract irritation or infection. If these particles persist or are accompanied by other symptoms, further evaluation may be necessary.


Recommended Next Steps:
1. Follow-Up Testing: It is crucial to continue monitoring your urine for RBCs. Regular urinalysis can help track any changes in RBC counts and other parameters.

2. Imaging Studies: If the hematuria persists, your healthcare provider may recommend imaging studies such as an ultrasound or CT scan to assess for any structural abnormalities in the urinary tract, including stones or tumors.

3. Cystoscopy: If other tests do not yield a clear cause, a cystoscopy may be warranted. This procedure allows direct visualization of the bladder and urethra, helping to identify any lesions or abnormalities.

4. Consultation with a Urologist: Given the complexity of your symptoms and history, consulting a urologist may provide more specialized insight into your condition and guide further management.

In conclusion, while the presence of RBCs in urine can be concerning, it is essential to approach the situation with a comprehensive evaluation to determine the underlying cause. Regular follow-ups and appropriate testing will be key in managing your health effectively. Always communicate openly with your healthcare provider about any new symptoms or concerns you may have.