Hematuria Without Bacteria: Urology Insights

Q: Hematuria Without Bacteria: Urology Insights

Hello： <br>1. <br>Is it possible that the urine test was related to the discharge? (I previously had a urinary tract infection but did not have blood in the urine) --> A urine test is a simple examination, but results can vary each time due to the body's condition and food intake

Urinary occult blood without bacteria?

Hello Doctor, I experienced recurrent urinary tract infections earlier this year and in the middle of the year.
After actively increasing my water intake (at least 1500 ml per day), along with taking cranberry probiotics and doing iodine sitz baths, the occurrences have decreased.
However, on Saturday, I felt discomfort again (mainly a burning sensation while urinating, though not severe, and some lower abdominal pain), so I visited a gynecologist.
The gynecologist performed a urinalysis which showed no bacteria but some slight traces of blood.
The pelvic examination did not reveal any abnormalities, and it was determined that it was not caused by a vaginal infection.
I was prescribed a three-day course of medication for a urinary tract infection (antibiotics, diuretics, and pain relievers), and the doctor mentioned it could be due to stones or a very mild infection.
However, today, on the third day of taking the medication, I suddenly noticed blood-tinged discharge before my period (which was not present two days ago on Saturday).
I would like to ask the doctor: 1.
Is it possible that the urinalysis result was related to the discharge? (I did not have blood traces in my previous urinalysis for urinary tract infections.) 2.
Should I see a urologist for further examination, or is it sufficient to return to the gynecologist for another urinalysis? Thank you, Doctor.

Miao Miao, 20~29 year old female. Ask Date: 2021/11/15

Dr. Du Shixi reply Urology

Hello:
1.
Is it possible that the urine test was related to the discharge? (I previously had a urinary tract infection but did not have blood in the urine) --> A urine test is a simple examination, but results can vary each time due to the body's condition and food intake, making it difficult to determine.
2.
Do I need to see a urologist for further examination, or can I just return to the obstetrics and gynecology department for another urine test? --> If there are urinary symptoms, it is advisable to see a urologist.
If there are none, and to confirm that menstruation has not occurred, then a visit to the urologist is recommended.
When collecting urine, it is important to collect a midstream sample.
Wishing you good health.

Reply Date: 2021/11/15

More Info

Hematuria, or blood in the urine, can be a concerning symptom, especially when it occurs without the presence of bacteria. In your case, it seems that you have a history of urinary tract infections (UTIs) and have been proactive in managing your symptoms through hydration and dietary supplements. However, the recent episode of hematuria, along with your discomfort, raises important questions regarding the underlying cause.

1. Possible Connection Between Hematuria and Discharge: It is indeed possible that the presence of blood in your urine could be related to the menstrual cycle or vaginal discharge. The urinary tract and the reproductive system are anatomically close, and sometimes, blood from the vagina can contaminate a urine sample, leading to a false impression of hematuria. If you had your menstrual cycle approaching, this could explain the blood in your urine. It’s important to ensure that urine samples are collected properly to avoid contamination.
2. Need for Further Urological Evaluation: Given that your urine test showed no bacteria but did reveal slight blood, it would be prudent to follow up with a urologist for further evaluation. While your gynecologist has ruled out vaginal infection, there are other potential causes of hematuria that should be investigated. These include:
- Kidney Stones: Even small stones can cause irritation and bleeding in the urinary tract.

- Urinary Tract Injury: Trauma or irritation to the urinary tract can lead to bleeding.

- Glomerular Disease: Conditions affecting the kidneys can also result in blood in the urine.

- Tumors: Though less common, both benign and malignant tumors in the urinary tract can cause hematuria.

A urologist may recommend imaging studies such as an ultrasound or CT scan to visualize the urinary tract and identify any abnormalities. Additionally, a cystoscopy, which involves inserting a camera into the bladder, may be warranted if there are persistent symptoms or if the imaging studies reveal any concerning findings.

3. Monitoring Symptoms: It is essential to monitor your symptoms closely. If you experience worsening pain, increased frequency of urination, or any new symptoms such as fever or chills, you should seek medical attention promptly.
4. Follow-Up with Your Gynecologist: Since you mentioned the appearance of blood-tinged discharge, it would also be wise to follow up with your gynecologist. They may want to perform additional tests to rule out any gynecological issues that could be contributing to your symptoms.

In conclusion, while the absence of bacteria in your urine is a positive sign, the presence of hematuria warrants further investigation to rule out any serious underlying conditions. It is advisable to consult with a urologist for a comprehensive evaluation and to ensure that any potential issues are addressed promptly. Additionally, maintaining hydration and continuing your current management strategies can help support your urinary health.

Similar Q&A

Understanding Hematuria: Causes and When to Seek Medical Help

Blood in the urine, sometimes appearing as blood streaks, without accompanying lower back pain or a burning sensation during urination, can have several potential causes. Since the urine test showed traces of blood but no bacteria, it may suggest a few possibilities such as: 1. ...

Dr. Li Xinyi reply Urology
Given your age, the most likely cause is a stone. You should see a urologist for an examination and discuss it with your doctor!

Understanding Hematuria: Causes and Considerations in Urology

Blood in urine without abdominal distension or discomfort.

Dr. Pan Zhenqin reply Urology
A: Common causes of hematuria in young women include bladder inflammation or urinary tract stones; however, these conditions typically present with additional symptoms such as dysuria, frequency, or flank pain. It is also possible for hematuria to occur without accompanying sympt...

Morning Hematuria: Understanding Causes and Concerns

Hello Doctor: Recently, when I wake up in the morning and go to the bathroom, there is no blood in my urine, and everything seems normal. However, after I started working, I noticed that when I go to the bathroom, I have blood in my urine, but there is no pain, just a feeling of ...

Dr. Li Yilun reply Urology
Your symptoms may indicate a urinary tract infection, which can include urethritis, cystitis, or pyelonephritis. Any infection of the urinary system falls under this category and is typically caused by bacteria. Generally, antibiotic treatment is required. It is advisable to visi...

Understanding Painless Hematuria: Possible Causes and Concerns

Hello, doctor. I have searched through the question bank and found no similar issues, so I am inquiring. I have been living abroad for four months, and two weeks ago, I noticed blood on the toilet paper after urinating, but there was no blood in the toilet. It doesn't happen...

Dr. Du Shixi reply Urology
Hello: Based on your description, the urine in the toilet appears to be blood-free, but since there is blood on the toilet paper, it is still advisable to have both gynecological and rectal examinations confirmed by a physician. If there is blood in the toilet, further examinatio...