Persistent Hematuria: When to Consult a Urologist - Urology

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Persistent hematuria, or the presence of blood in the urine, can be a concerning symptom that warrants thorough investigation, especially when it has been ongoing for several years. In your mother's case, the fact that she has experienced microscopic hematuria since 2017, along with symptoms such as burning sensation and frequency of urination, suggests that there may be an underlying issue that needs to be addressed.

Given the history of hematuria and urinary symptoms, it is essential to consider various potential causes. These can range from benign conditions, such as urinary tract infections (UTIs), to more serious issues, including kidney stones, bladder or kidney tumors, or even glomerular diseases. The presence of a uterine fibroid, while typically not directly related to hematuria, could indicate that there are multiple factors at play affecting her urinary health.

The fact that your mother has had consistent microscopic hematuria for five years, even in the absence of pain, is particularly noteworthy. It is crucial to continue monitoring this condition closely. While the absence of pain may seem like a positive sign, it does not eliminate the need for further evaluation. The presence of blood in the urine, even if not visible to the naked eye, should always be taken seriously.

In terms of next steps, I would recommend the following:
1. Consult a Urologist: Given the persistent nature of the hematuria, it is advisable for your mother to continue seeing a urologist. A urologist specializes in urinary tract issues and can perform necessary diagnostic tests, such as a cystoscopy, to visualize the bladder and urethra directly. This can help rule out any tumors or other abnormalities that may not be evident through imaging studies alone.

2. Further Testing: Depending on the urologist's assessment, additional tests may be warranted. This could include imaging studies like a CT scan or ultrasound to evaluate the kidneys and bladder for stones or masses. Urine cytology may also be performed to check for cancerous cells.

3. Monitor Symptoms: Keep a close eye on any changes in symptoms. If your mother experiences any new symptoms, such as increased pain, changes in urinary habits, or visible blood in the urine, it is essential to seek medical attention promptly.

4. Consider Other Specialists: If the urologist does not find a clear cause for the hematuria, it may be beneficial to consult a nephrologist (a kidney specialist) to evaluate for potential kidney-related issues. Additionally, if there are concerns about the uterine fibroids and their potential impact on urinary symptoms, a gynecologist may also provide valuable insights.

5. Lifestyle and Preventative Measures: Encourage your mother to stay well-hydrated, as adequate fluid intake can help dilute the urine and may reduce irritation in the urinary tract. Additionally, maintaining good hygiene and promptly addressing any urinary symptoms can help prevent infections.

In conclusion, while the absence of pain is a positive development, the persistent hematuria requires ongoing evaluation and monitoring. Consulting a urologist for further assessment and potential diagnostic testing is the best course of action to ensure that any underlying issues are identified and appropriately managed. It is essential to remain vigilant and proactive in addressing any urinary symptoms to safeguard your mother's health.