Is Blood in Urine Normal Two Weeks After Extracorporeal Shock Wave Lithotripsy? - Urology

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Experiencing blood in the urine (hematuria) after undergoing Extracorporeal Shock Wave Lithotripsy (ESWL) is not uncommon, especially within the first couple of weeks following the procedure. ESWL is a non-invasive treatment used to break down kidney stones into smaller fragments that can be passed more easily through the urinary tract. While the procedure is generally safe and effective, it can lead to some temporary side effects, including hematuria.


Understanding Hematuria Post-ESWL
1. Causes of Blood in Urine: After ESWL, the shock waves can cause trauma to the kidney and surrounding tissues, which may lead to bleeding. The presence of blood in urine can be attributed to:
- Tissue Trauma: The shock waves can cause minor injuries to the renal parenchyma (the functional tissue of the kidney) and the ureter, leading to bleeding.

- Stone Fragment Passage: As the broken stone fragments move through the urinary tract, they can irritate the lining of the ureter and bladder, causing bleeding.

- Infection: Sometimes, the procedure can lead to urinary tract infections (UTIs), which can also cause hematuria.

2. Normal vs. Abnormal Symptoms:
- Normal: Occasional blood in the urine, especially if it is not persistent and is accompanied by mild discomfort, can be considered a normal response to the procedure. It is common for patients to notice blood in their urine intermittently for a few days to weeks after ESWL.

- Abnormal: If the hematuria is persistent, accompanied by severe pain, fever, chills, or if there are significant changes in urinary habits (such as increased frequency or urgency), it may indicate complications such as infection or obstruction, and you should seek medical attention promptly.


Recommendations
- Monitoring Symptoms: Keep track of the frequency and amount of blood in your urine. If it becomes more pronounced or is accompanied by other concerning symptoms, it is advisable to contact your healthcare provider.

- Follow-Up Appointments: Since your doctor has advised a follow-up in two weeks, it is essential to keep that appointment. During this visit, your doctor will likely perform imaging studies to assess the status of the kidney stones and check for any complications.

- Hydration: Ensure you are drinking plenty of fluids, as this can help flush out the urinary system and may assist in passing any remaining stone fragments.


When to Seek Immediate Care
If you experience any of the following, you should seek immediate medical attention:
- Persistent or worsening hematuria.

- Severe abdominal or flank pain that is not relieved by over-the-counter pain medications.

- Fever or chills, which may indicate an infection.

- Nausea or vomiting that prevents you from keeping fluids down.

In summary, while some blood in the urine can be a normal occurrence following ESWL, it is crucial to monitor your symptoms closely. If you have any concerns or if your symptoms worsen, do not hesitate to reach out to your healthcare provider for further evaluation. Your health and well-being are paramount, and timely medical advice can help ensure a smooth recovery.