Blood in the Urine
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I have blood in my urine. My doctor checked my bladder with a scope twice and said it looks fine. I have back problems and take a lot of medication for the pain — I wonder whether this might have anything to do with the blood I'm seeing. Any suggestions?
— Sandra, West Virginia
Blood in the urine can be a sign of intrinsic kidney disease, kidney stones, tumors of the upper and lower urinary tract, and a number of other things, including a urinary tract infection.
Cystoscopy is a procedure by which a urologist looks at the bladder to inspect its lining and the urethra, the tube that leads from the bladder to the outside of the body. Another important step in the evaluation of blood in the urine is the assessment of the upper urinary tract. This is usually performed with a CT scan that images the kidney and the lining of the urinary tract, from the kidney all the way to the bladder.
Chronic pain requiring extensive oral medications can lead to a number of conditions, including kidney damage and bleeding. If a standard evaluation of the upper urinary tract (with CT) and lower urinary tract (with cystoscopy) fails to find any abnormalities, the possibility of intrinsic kidney disease should be considered. Analysis of the urinary sediment (the solid particles in the urine) can detect signs of intrinsic kidney disease. Results of such a urinalysis are usually evaluated by a physician trained as a nephrologist.
Video: "Is Blood in the Urine Normal?" with Dr. Melanie Crites-Bachert (360phi.com)
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