Blood in Urine: Causes and When to Seek Help

Q: Blood in Urine: Causes and When to Seek Help

Hello Anita： You likely have a urinary tract infection (UTI) and should seek medical attention at a hospital as soon as possible. <br>1. <br>A cold will not lead to a concurrent infection of the urinary and reproductive systems. <br>2. <br>Infections of the urinary and reproducti

Blood in urine?

Hello doctor, I have a question.
Last weekend, I had sexual intercourse with my boyfriend (after oral sex followed by vaginal intercourse) while I was experiencing a cold.
On Sunday morning, my boyfriend took me strawberry picking, and I ate a lot of unwashed strawberries.
Later, on Monday afternoon, I suddenly felt unwell, and by evening, I started to have a fever and severe diarrhea.
I felt nauseous and needed to use the restroom every two minutes, but only a few drops would come out.
After using the restroom, I experienced a burning pain, and when I wiped, I noticed blood.
My mother suggested it might be a urinary tract infection.
On Tuesday morning, I went to a small clinic, and the doctor gave me an IV.
By the afternoon, the frequent urination improved, but I still had ongoing pain when urinating.
However, the fever subsided.
Later that day, around 5 PM, I vomited all the food I had eaten that day and the day before.
Since my menstrual period had just ended, I was using panty liners, and about every 3 to 4 hours, I noticed 2-3 drops of bright red blood, which made me suspicious.
It didn't look like the dark brown blood typically seen at the end of a period, so I instinctively felt it wasn't leftover menstrual blood.
I'm confused about whether the blood is coming from the vagina or the urethra; I just know it hurts a lot.
The doctor mentioned prescribing medication for the urinary tract infection, which could cause red urine, but I can tell the color is different from blood.
The doctor also said that to recover from a urinary tract infection, I need to take medication and drink plenty of water (over 2000cc).
Today is Wednesday, and I am still experiencing severe diarrhea.
For breakfast and lunch, just seeing food makes me want to vomit, and even my favorite water is hard to drink.
I forced myself to drink, and by evening, I continued taking the cold medication prescribed by the doctor.
My cold symptoms have improved significantly, and I no longer have a fever or pain when urinating.
I was able to eat dinner without feeling nauseous.
However, around 8 PM while watching TV, I suddenly felt pain and went to the restroom, and sure enough, there was blood on the panty liner again.
Is this normal? I've been drinking a lot of water (about 3000cc today, which is no exaggeration).
Why would I still experience sudden pain and bleeding in the evening? My mother suggested that having sexual intercourse during my menstrual period might have caused the urinary tract infection.
Is this true? I know that women have weaker resistance in the vagina during their period.
(1) Could the cold virus have been transmitted through oral and vaginal sex, causing my bleeding? If so, could my vagina or uterus be infected and eroding, leading to bleeding? (2) Why would intercourse lead to a urinary tract infection instead of vaginitis? (3) My boyfriend suggested that I might have gotten food poisoning from the unwashed strawberries, which could explain the diarrhea and bleeding.
If pesticide residue on strawberries exceeds safety standards, could it cause symptoms like mine (I ate about 15 strawberries)? (4) If I continue to experience sudden abdominal pain and bleeding in the next couple of days, should I see a doctor again? What kind of examination should I undergo? Should I see a gynecologist, urologist, or a general practitioner? What tests would be best? Thank you for taking the time to read my long message with so many questions.
I'm really confused and don't know what to do, so I wanted to describe my situation in detail.
I hope you can provide me with answers based on my description.
Thank you again for your patience in reading my letter, and I look forward to your response.
P.S.
Could you please reply via email instead of posting it online? Thank you very much.

A Zhu, 20~29 year old female. Ask Date: 2004/01/14

Dr. Zhang Chengye reply Urology

Hello Anita: You likely have a urinary tract infection (UTI) and should seek medical attention at a hospital as soon as possible.
1.
A cold will not lead to a concurrent infection of the urinary and reproductive systems.
2.
Infections of the urinary and reproductive systems often occur due to the presence of normal flora in the vagina.
3.
This should not be a symptom of poisoning.
4.
For issues related to vaginal bleeding, you may consult a gynecologist.
P.S.: Due to issues with the online hospital system, we have a unified management and dispatch system, so...
I apologize! Dr.
Chang Cheng-yeh, Attending Physician, Urology Department, Hsinchu Hospital, Department of Health, Executive Yuan.

Reply Date: 2004/01/14

More Info

Based on the information provided, it seems that the young boy diagnosed with Ewing's Sarcoma is experiencing complications related to his chemotherapy treatment, specifically symptoms of bladder inflammation and hematuria (blood in urine). Here’s a detailed response addressing the questions raised, along with relevant medical insights.

1. Potential for Permanent Damage: The occurrence of hematuria and bladder inflammation following chemotherapy, particularly with agents like Ifosfamide, is not uncommon. Ifosfamide can irritate the bladder and lead to a condition known as hemorrhagic cystitis. While this can be painful and distressing, most cases resolve with appropriate hydration and supportive care. The risk of permanent damage to the bladder or kidneys is generally low if the symptoms are managed promptly. However, ongoing monitoring is essential, especially if blood in the urine persists. The doctor’s assertion that there is no kidney damage is reassuring, but it is crucial to continue monitoring kidney function as a precaution.

2. Possibility of Kidney Damage: Although the doctor indicated no kidney damage, it is wise to remain vigilant. The kidneys can be affected by various factors, including dehydration and the toxicity of chemotherapy agents. If the boy continues to experience symptoms or if there are changes in kidney function tests, further evaluation may be warranted. It is important to trust the medical team but also to advocate for the patient's health by asking for additional tests if concerns arise.

3. Diagnosis Accuracy: Ewing's Sarcoma is a well-defined entity in pediatric oncology, and the diagnosis is typically based on histological examination and imaging studies. While different doctors may have varying opinions, the diagnosis of Ewing's Sarcoma is generally reliable when made by experienced pathologists. If there are lingering doubts about the diagnosis, seeking a second opinion from a pediatric oncologist could provide reassurance and clarity.

4. Seeking a Second Opinion: It is entirely reasonable for the family to seek a second opinion, especially in complex cases involving cancer treatment. Consulting with a pediatric oncologist who specializes in Ewing's Sarcoma can provide additional insights and confirm the current treatment plan. It is essential to ensure that the patient receives the best possible care and that all concerns are addressed.

5. Legal Actions Against the Hospital: If the family believes that the hospital's error in administering chemotherapy has led to significant harm, they may consider consulting with a medical malpractice attorney. Documenting all medical records, treatment plans, and any changes in the patient's condition will be crucial. It is also important to communicate openly with the healthcare team about any concerns regarding the treatment and to ensure that the hospital is aware of the situation.

In summary, while the complications arising from chemotherapy can be concerning, they are often manageable with appropriate medical care. Continuous monitoring and open communication with healthcare providers are vital. If symptoms persist or worsen, further evaluation and intervention may be necessary. The family should feel empowered to seek additional opinions and advocate for the best care for their child.

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