Should I Recheck Persistent Urinary Blood After 7 Years?

Urinary occult blood 1+

I would like to ask the doctor, seven years ago during a health check, I found out I had urine occult blood 1+.
I consulted a urologist, and at that time, I underwent a kidney ultrasound and a renal venography, both of which were normal.
Seven years later, during this year's health check, I still have urine occult blood 1+.
Do I need to undergo further testing? I am concerned about the potential harm of excessive X-ray exposure to my body.

Mr. Wang, 40~49 year old female. Ask Date: 2015/11/08

Dr. Liao Yaopan reply Family Medicine

Hello, urine occult blood is tested using a test strip; however, to confirm if it is hematuria, a microscopic examination of the urine sediment is necessary.
If hematuria is present, it is advisable to investigate the underlying cause.
Changhua Hospital cares about you.

Reply Date: 2015/11/08

More Info

It is understandable to be concerned about persistent urinary blood, especially after a previous finding of hematuria (blood in urine) seven years ago. Given your history and the current situation, it is advisable to consider a follow-up evaluation.

Persistent hematuria can have various causes, ranging from benign conditions to more serious underlying issues. Since you have already undergone imaging studies such as renal ultrasound and venography, which returned normal results, it is reassuring. However, the persistence of hematuria indicates that further investigation may be warranted.

Here are several points to consider regarding your situation:
1. Reevaluation of Hematuria: It is crucial to follow up on persistent hematuria. While your previous tests were normal, the fact that you are still experiencing blood in your urine suggests that there may be an underlying issue that needs to be addressed. Conditions such as urinary tract infections, kidney stones, or even more serious conditions like tumors can cause hematuria.
2. Non-Invasive Testing Options: If you are concerned about the exposure to radiation from imaging studies, there are non-invasive tests that can be performed. For example, a urinalysis can provide valuable information about the presence of blood, protein, or signs of infection. Additionally, a urine culture can help identify any underlying infections that may be causing the hematuria.

3. Consultation with a Urologist: Given your history and the persistence of hematuria, it would be prudent to consult a urologist. They can perform a thorough evaluation, which may include a cystoscopy (a procedure to look inside the bladder) if deemed necessary. This procedure is typically done under local anesthesia and can provide direct visualization of the bladder and urethra.

4. Monitoring and Follow-Up: If your urologist determines that further imaging or testing is not immediately necessary, they may recommend regular monitoring of your condition. This could involve periodic urinalysis to check for changes in your hematuria status.

5. Understanding Risks and Benefits: It is essential to weigh the risks and benefits of any further testing. While excessive exposure to radiation is a valid concern, the potential benefits of identifying a treatable condition far outweigh the risks associated with imaging.
6. Lifestyle and Health Considerations: Maintaining a healthy lifestyle, including staying hydrated and avoiding irritants such as caffeine and alcohol, can also help manage urinary health. If you have any other symptoms, such as pain during urination, frequent urination, or changes in urinary habits, be sure to discuss these with your healthcare provider.

In conclusion, while it is understandable to be apprehensive about further testing due to concerns about radiation exposure, the persistence of urinary blood is a significant finding that should not be ignored. A follow-up evaluation with a urologist is recommended to ensure that any potential underlying issues are addressed appropriately. Regular monitoring and a proactive approach to your urinary health will help ensure that any concerns are managed effectively.

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