Persistent Hematuria: When to See a Urologist or Gynecologist

Q: Persistent Hematuria: When to See a Urologist or Gynecologist

Hello, A-Zeng： Hematuria is a warning sign! Please rule out the possibility of urine testing during your menstrual cycle, as there should not be any hematuria outside of that period. <br>I recommend that you visit a hospital for a urinary system ultrasound. <br>If necessary, you

Urine occult blood detected during health check-up?

Hello Doctor, two years ago, due to gynecological issues, I underwent regular urine tests every three months at the hospital, and the doctors consistently reported hematuria.
Initially, they attributed it to inflammation, but since it was detected each time, I later had an abdominal ultrasound, which indicated that my kidneys seemed to be fine.
In May of last year, during a health check I arranged myself, hematuria was detected again, but during a prior gastrointestinal endoscopy check just a week earlier, it was not present.
Later, in December, during a company health check, hematuria was also detected (I recall it being 3+).
Both health checks included abdominal ultrasounds, and my kidneys showed no issues.
Aside from occasional urinary frequency, I have no other symptoms, but hematuria consistently appears in my urine tests (except for that one during the gastrointestinal endoscopy).
Should I consult a urologist or a gynecologist? Besides the abdominal ultrasound, what other tests might be necessary? Could this long-term condition lead to serious issues? Thank you in advance for your response!

A Zeng, 20~29 year old female. Ask Date: 2023/02/12

Dr. Sun Hongshun reply Urology

Hello, A-Zeng: Hematuria is a warning sign! Please rule out the possibility of urine testing during your menstrual cycle, as there should not be any hematuria outside of that period.
I recommend that you visit a hospital for a urinary system ultrasound.
If necessary, you may also need a urine cytology test or a cystoscopy to determine the exact cause.

Reply Date: 2023/02/12

More Info

Persistent hematuria, or the presence of blood in the urine, can be a concerning symptom that warrants further investigation. Given your history of recurrent urinary tract issues and the consistent findings of hematuria during your medical check-ups, it is essential to approach this situation with a comprehensive understanding of potential underlying causes and the appropriate steps to take.

Firstly, it is important to note that hematuria can arise from various sources within the urinary tract, including the kidneys, ureters, bladder, and urethra. In your case, since you have undergone abdominal ultrasound examinations that did not reveal any abnormalities in the kidneys, it is crucial to consider other potential causes. Common reasons for hematuria include urinary tract infections (UTIs), kidney stones, trauma, tumors, or benign conditions such as cysts or polyps.

Given that your hematuria has been persistent and recurrent, it would be prudent to consult with a urologist. Urologists specialize in the urinary tract and male reproductive system, making them well-equipped to evaluate and manage conditions related to hematuria. They may recommend additional diagnostic tests, such as a urinalysis, urine culture, or imaging studies like a CT scan or cystoscopy, which allows direct visualization of the bladder and urethra. These tests can help identify any abnormalities that may not have been detected through ultrasound alone.

While gynecological issues can sometimes present with urinary symptoms, your ongoing hematuria suggests that a urological evaluation is more appropriate at this stage. Gynecological conditions, such as pelvic masses or endometriosis, can occasionally cause urinary symptoms, but they are less likely to be the primary cause of persistent hematuria. If the urologist rules out any urinary tract issues, then a referral to a gynecologist may be warranted to explore any potential gynecological contributions to your symptoms.

In terms of the severity of your condition, persistent hematuria should not be taken lightly. While it may not always indicate a serious underlying condition, it is essential to investigate further to rule out any significant issues, such as tumors or other pathologies. Early detection and management of any underlying conditions can significantly improve outcomes and prevent complications.

In summary, based on your history and the persistent nature of your hematuria, I recommend scheduling an appointment with a urologist for a thorough evaluation. They will be able to conduct the necessary tests to determine the cause of your hematuria and recommend appropriate treatment options. If any gynecological issues are identified during this process, they can coordinate care with a gynecologist as needed. Taking these steps will help ensure that you receive the appropriate care and peace of mind regarding your health.

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