unexplained blood in urine

[Jul334]

I am a  48 year-ol-female, who has unexplained blood in my urine occassionaly.  I also have ulcerative colitis,  diverticulosis and a host of other medical conditions.  I take the following medications: Estradiol 1 mg/1 x day; Levoxyl 50mcg/ 1 x day; Asacol 400 mg 3 tabs 2xday; Hydorochlorot 50 mg/1xday;Lyrica 100 mg/1 tab 2x day; Zetia 10mg/ 1x day; and Ultram WR 100mg/1 tab a day as needed for pain.  I have been having blood in my urine on occasion since Dec. of 2007, which does not show any indication of infection.  I had a bladder and kidney ultra sund with the results coming back normal.  I only have this blood when I do more than I normally do or when I have high level of stress. Also, this blood is only present for 3 to 4 days after I do more than usual or have more stress and it is only present in the first two urinations of the day, and I have more pain in my back when I have the blood in my urine.  The blood in the urine is more of a cranberry color at first and then by the fourth day it is a tinge of red  I also want to mention that I had a Lumber Spine fusion in 2006, in which they did the surgery through the abdomen, but I do not know if this is conected to the symptoms mentioned.  I keep asking my primary care doctor what else it could be but she has no answer and had told her staff to set me up with an urologist for further evaluation in January of 2008, but so far I haven not been referred to anyone. Any idea on what could be causing this blood in my urine?
Jul334

[Jul334]

Hi,

My primary doctor just did a culture in her office, she did not send me to the lab for further testing of the urine, so I don't have an answer about crystals or casts, just that there was no findings of blood in the urine.

I have had several abdominal surgeries, I had a hysterectomy at age 27, ovaries removed when I was 41, an additional surgery when I was 42 to remove a piece of ovary that was left in during the first surgery and at 46 the Lumber spine fusion which was done through the abdomen.  

Since the Lumber spine fusion, I am unable to work and can not engage in any type of exercise except swimming, which I do not know how to do anyway. I also have chronic nerve denervation in my left leg.  I have to limit myself on how much housework I do everyday due to the pain and fatigue.  If I do more housework than what I normally do that is when I get the bleeding or if I get stressed out more than usual I bleed and now there has been some upper abdominal pain also.

I woke up this morning with a more severe back pain than usual and when I urinated, there was blood present again.  It seems like the blood is "pooling" at night and then it takes three urinations to flush it out.

I have a feeling that my doctor is not taking this seriously enough. As I stated in my original question, in January my doctor's staff suppose to set me up with a few referrals but never did that.  I have called several times to question them about it and they tell me that they will be callling me back in the afternoon (on the day I call) but they never do.  I did this three times since the end of January and finally I just called and set up another appointment with her.

I also want to mention that my 22 year-old-daughter has just been diagnoised with Moya-Moya, Factor Five (both genetic diseases) and a hole in her heart.  Could there be a chance that any of this could be a factor in what I am experiencing?  I am also a carrier of the A-T Gene, which makes me a higher risk for cancers, especially breast cancer.  Could this be a concern also?

I have low potassium, which was diagnoised in Nov of 2007.  I was on Klor-con, but had an allergic reaction to it.  My physician perscribed another potassium medication which is very expensive and my husband's insurance refuses to pay for without prior authorization.  The pharmacy has faxed over the refusal to the doctor and has not heard back from her, this has been since early January also.  I have the leg cramping from the low potassium and I have been eating bananas and oranges but they do not help much. Could this also be contributed to the blood in the urine?

Also, when I had my first colonoscopy at the age of 40, I was told that I had the worst type of pre-cancerous polyp that a person could get without it being cancer already.  I have had two colonoscopies since then with the last one being free of any polyps. I have internal hemorrhoids. Could this cause the bleeding too?

I am getting scarred and upset over this bleeding which isn't helping the bleeding situation. I feel totally helpless and in order for me to see any specialists, I need to be referred, but if the doctor's staff will not make the appointments, I can't get this taken care of. What else can I do?

[Vanessa Lacuesta]

Hi,

What other findings were present in your urinalysis ?

Were there crystals or casts?

Were there instances that your stools became dark colored or had bowel movement been associated wth some degree of bleeding recently?

Any previous abdominal surgeries or gynecologic instrumentation?

Hematuria, especially gross or visible hematuria need to be further evaluated. The urethra, bladder or kidneys may be involved. An abdominal CT scan may be able to help. If this comes back clear a cystoscopy and urine void cytology may be able to shed some light.
You also need to be further evaluated in terms of bleeding disorders and your kidney function. BUN and Creatinine levels need to be determined as well as a 24 hour urine collection.


Your gastrointestinal condition need to be followed up also. Avoid any strenuous activities and vigorous exercises.Discuss this with your primary physician so that you may be readily referred to a urologist.