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PostPosted: Thu Feb 08, 2007 5:34 pm 
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Location: Chiang Mai



Lisa wrotes: Hi
I would like some advice on microscopic haemituria please. During my routine smear test my urine was checked and blood was found on the labstix. A specimen was sent off and came back clear so my Gp did another one to make sure which came back with red blood cells present.

She has now referred me to a urologist. Is this a precaution? I feel a bit of a fraud going to see him as I have no pain and no frequency. Does it require investigation? and can you advise on what tests the urologist may do please.

Thanks Lisa


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PostPosted: Thu Feb 08, 2007 5:35 pm 
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Hi lisa,
When the urine looks normal and blood is detected only by microscopic examination , the condition is known as Microscopic haematuria. A normal individual can excrete small amount of blood in urine daily ( up to one million red blood cells (RBC) in the urine each day) and the condition is not considered hematuria.
In females, hematuria is common due to the high incidence of urinary tract infection (due to their short urethra). Urinary tract infection is usually associated with burning micturition, frequency and urgency.
Other conditions that lead to hematuria include
Kidney and ureteric stones , in which pain (colicky ) is usually present.
Kidney disease, such as nephritis .
Medications such as Warfarin, Aspirin, Ibuprofen and naproxen
To investigate the cause your doctors would recommend you one or more of the foll lowing tests , after complete history and physical examination,
Urine tests (urinalysis), in this case not only to check for blood in urine but also for pus cells which if present indicate the presence of infection. Urine Culture is to be considered in this condition.
Blood tests to check also for infection and to rule out any systemic causes of bleeding tendency.
Kidney, ureter and bladder-imaging with (IV) or without dye stenography or X- ray, to detect stones or any masses.
If no cause is found but the condition is persistent or increasing, Cystoscopy, is rec commended to visualize the urethra and bladder
Best regards,
_________________
This answer does not substitute for direct medical consultation.

Dr. Safaa Mahmoud.
MB, BCh, MSc.
Internal Medicine. Medical Oncology.
PhD Biochemistry and Biochemical Science.

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