Blood in Urine After Urination: When to See a Urologist or Gynecologist?

Hematuria after urination?

I have been experiencing blood in my urine recently, which doesn't seem to resemble menstrual blood in color or odor.
Sometimes it's present, and sometimes it's not; it's not a lot, but it's also not negligible.
Generally, the blood appears only when I urinate, unlike menstrual bleeding, which can occur at any time and stain my underwear.
I had a period about two months ago, but it's not close to my expected menstrual cycle (about 10 days away), and I don't feel any bloating or discomfort in my abdomen.
About two weeks ago, I had inflammation in my urethra and took medication for a urinary tract infection.
I'm unsure what is going on...
Should I see a urologist or a gynecologist? I hope to get some answers so I can stop worrying.

Niming, 20~29 year old female. Ask Date: 2016/03/03

Dr. Li Xinyi reply Urology

You definitely need to see a urologist for an examination.

Reply Date: 2016/03/03

More Info

Blood in urine, or hematuria, can be a concerning symptom that warrants medical attention. Given your description, it seems that the blood appears after urination and is not consistent with menstrual bleeding, which is an important distinction. Here’s a breakdown of what you should consider and the steps you might take.

When to See a Urologist or Gynecologist
1. Urologist: Since the blood is present after urination, it is advisable to first consult a urologist. Urologists specialize in the urinary tract and male reproductive system, and they can evaluate potential causes of hematuria, such as urinary tract infections (UTIs), kidney stones, or other underlying conditions affecting the bladder or kidneys. Given that you mentioned a recent history of urinary tract inflammation and treatment for cystitis, it’s possible that the inflammation could be contributing to the bleeding.

2. Gynecologist: If the urologist rules out urinary tract issues, or if there are additional gynecological symptoms (such as unusual vaginal discharge, pelvic pain, or changes in menstrual cycle), then it may be appropriate to see a gynecologist. They can evaluate for any potential gynecological causes of bleeding, such as fibroids, polyps, or other conditions affecting the reproductive system.

Symptoms to Monitor
- Color and Consistency of Blood: Note the color of the blood. Bright red blood often indicates fresh bleeding, which could be from the bladder or urethra, while darker blood may suggest bleeding from higher up in the urinary tract.

- Associated Symptoms: Pay attention to any accompanying symptoms such as pain during urination, frequent urination, abdominal pain, or fever. These can provide important clues to your healthcare provider.

- Duration and Frequency: Keep track of how often you experience this symptom and whether it is getting worse or improving.

Next Steps
1. Schedule an Appointment: Given your symptoms, it would be prudent to schedule an appointment with a urologist as soon as possible. They may perform a urinalysis, imaging studies (like an ultrasound or CT scan), or a cystoscopy to visualize the bladder and urethra directly.

2. Prepare for Your Visit: When you see the doctor, be prepared to provide a detailed history of your symptoms, any medications you are taking, and any previous urinary or gynecological issues. This information will help your doctor make an accurate diagnosis.

3. Follow-Up: Depending on the findings, your doctor may recommend further testing or treatment. If a urologist identifies a urinary issue, they may provide treatment options. If gynecological issues are suspected, a referral to a gynecologist may be necessary.

Conclusion
In summary, given your symptoms of blood in urine, it is advisable to consult a urologist first. They can assess for urinary tract issues and determine the appropriate course of action. If necessary, they can refer you to a gynecologist for further evaluation. Early diagnosis and treatment are crucial in addressing any underlying conditions and alleviating your concerns. Don’t hesitate to seek medical attention, as timely intervention can lead to better outcomes.

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