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Dr. David
Dr. David, Board Certified MD
Category: Medical
Satisfied Customers: 42812
Experience:  Board Certified Physician
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Hello, I am a 30 year old male. I had non bacterial prostatitis

Customer Question

Hello,

I am a 30 year old male. I had non bacterial prostatitis two years ago which was treated with antibiotics and muscle relaxers. I occasionally get flare ups of symptoms that last a week or so and then go away. The last two days when urinating my urine is clear no burning or pain however there have been a couple of dark brown flakes passed in my urine. This has only happened two times and as mentioned no pain or burning. What could these flakes be? I have very little pain in my right Lower back that comes and goes and is not a stong pain at all it might even be back pain. I have seen my urologist and have had blood and urine analysis and I am going back next week for an ultrasoind of the bladder and kidney and results of urine and blood tests. I am quite worried as to what it might be?
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. David replied 3 years ago.
This is Dr. David

sometimes if you have some old blood in your bladder or small bladder stones, you can pass some small brown flakes in your urine.

a urinalysis can tell for sure if you have any blood in your urine which you can't see with your eyes.

a cystoscopy procedure can look up into the bladder to see if there is any active bleeding or any inflammation of the bladder wall.

if your urinalysis has been normal, that is reassuring.

hopefully the ultrasound will not show any inflammation of the bladder or bladder stones.

if everthing is normal, those small flakes could have just been some old tissue sloughing off of the inner wall of the bladder.

let me know if you have other questions.
Customer: replied 3 years ago.
I have not received the test results yet. My main concern is what would normally cause this? When pressing my lower abdomen it is slightly tender with a little pain. If this is bladder or kidney stones what treatment will be required? What does this sound like to you?
Expert:  Dr. David replied 3 years ago.
it doesn't sound like bladder or kidney stones which tend to be much more painful and tend to cause blood in the urine which would have been detected on the urinalysis.

I think those flakes were just old tissue which sloughed off the inside of the bladder wall and came out in the urine.

it will be important to see if there was any microscopic blood detected on the urinalysis.

if there are bladder stones found in the bladder, your urologist can go up into the bladder with a cystoscope and take the stones out.
Customer: replied 3 years ago.
But as mentioned I only did the urinalysis today so I do not know what the results will be. What about the prostatitis I mentioned above and also what about the small tender pain I feel when pressing my abdomen?
Expert:  Dr. David replied 3 years ago.
prostatitis can sometimes result in some blood as well which can sometimes come out in the urine.

prostatitis is normal sometimes and can come and go as you know.

most prostatitis is self limited and not a long term or serious problem.

the ultrasound can see more about what the small tender pain is in the abdomen. this could be from bowel inflammation or constipation. if the tenderness is mild, it might not be serious. don't let your worries get too out of control. it might not be related at all to what you saw in your urine.
Customer: replied 3 years ago.
Do any of these symptoms sound like cancer, either kidney cancer or prostate cancer? So just to conclude what do you think these particles might be, related to bladder stones or kidney stones? You said sometimes bladder stones can come out as brown particles. I looked at the particles they were like flakes and did not break up.
Expert:  Dr. David replied 3 years ago.
no, small red flakes in the urine once does not sound like cancer, not kidney cancer or prostate cancer.

I think the small flakes of brown are most likely old tissue being sloughed off of the wall of the bladder or some old blood in the prostate coming out in the urine. both of these are completely normal.

I don't think they were small bladder stones, more likely old blood from the prostate or bladder wall.
Customer: replied 3 years ago.
So you think this is old blood or old tissue? I have read that bladder stones can also be passed as brown particles? Also if it was blood would it not
Break up when I pick the flake up? This did not happen the flake was a solid flat flake which did not break up.
Expert:  Dr. David replied 3 years ago.
breaking up or no break up is not a reliable way to check for what is there.

if it was bladder stones which was passed, that is a completely normal process to have the stones come out of your body. usually bladder stones when they pass are painful and you didn't describe pain when these passed.

the urinalysis will show if there is still any blood in the urine. if you still have stones in your bladder, it most likely would cause some blood in your urine. if there is no blood, then most likely no more stones. the ultrasound can also see if there might be any more stones in your bladder.

Customer: replied 3 years ago.
Okay but what does this sound like to you? Do you think they are bladder stones or somethin else?
Expert:  Dr. David replied 3 years ago.
I think the brown flakes were old blood from the the prostate

I don't think they were bladder stones since it was not painful to pass them.
Customer: replied 3 years ago.

Okay but what could this be in your view? And have you heard of this before?
Expert:  Dr. David replied 3 years ago.
having a history of prostatitis, it is normal to sometimes have some old blood in the prostate which can sometimes come out in the urine.

it is normal to sometimes have some old blood mixed in with the sperm and come out in the ejaculate. this is called hematospermia. this is normal.

yes, I have heard of old blood coming out of the prostate in the urine or in the semen fluid.
Customer: replied 3 years ago.
So you think this is related to the prostatitis? What about the pain the lower abdomen?
Expert:  Dr. David replied 3 years ago.
this could be related to the prostate inflammation

or could be constipation or bowel gas or nothing at all if the pain is mild
Customer: replied 3 years ago.

The pain is in the abdomen is now stronger and also when I am passing urine I feel the pain in my bladder area and it is relieved by passing urine
Expert:  Dr. David replied 3 years ago.
this sounds very much like prostatitis pain.

you might need a course of antibitoics to treat the prostatitis.
Customer: replied 3 years ago.

The pain is in the lower part of the abdomen and in the last few hours I am having sharp on the right and left side of the lower back the pain seems to come and go continuously.
Expert:  Dr. David replied 3 years ago.
urinary track infect has to be checked for.

you need to follow up with your doctor and find the results of your urinanalysis test to see if you have an active urinary tract infection.
Customer: replied 3 years ago.

Could this also not be kidney sand or bladder sand?
Expert:  Dr. David replied 3 years ago.
what do you mean by kidney sand? or bladder sand?

Customer: replied 3 years ago.

I mean like stones but small ones due to the pain I am now feeling.
Expert:  Dr. David replied 3 years ago.
no, the pain that you are describing don't sound like bladder or kidney stones.

kidney and bladder stones cause much more pain.
Customer: replied 3 years ago.

But then what could be causing this kind of pain?
Expert:  Dr. David replied 3 years ago.
since you have had prostatitis before, then it is most likely prostatitis.

are you drinking plenty of water?

any further problems with urination?
Customer: replied 3 years ago.

Yes I am drinking water as much as possible, no further problems with urination only sometimes a split stream at the start or at the end of urination but the the stream is not weak.
Expert:  Dr. David replied 3 years ago.
I see.

I would try not to stress about those red flakes that you saw in your urine

your doctors have run the appropriate tests for you.

I don't think you have bladder or kidney stones since you did not have pain with urination.

it is common to have some old brown blood which can come from prostatitis and come out in the urine.

I'm glad that your urination is working well.

let me know what your testing shows and if you have other questions

please click accept and leave positive feedback below so I can get credit for helping you today

you can always reach me with "a question for Dr. David" if you have any other questions

Thanks for using JustAnswers.com
Customer: replied 3 years ago.

Yes the results of my urine and blood analysis were clear, also my ultrasounds showed a normal prostate so the urologist said that all my blood work and results were normal. I also had an x ray of the abdomen and I got a DVD too take away, I just had a question on the x ray, within the picture of my bladder on the x ray I noticed some dark brown circle like things I was wondering what these could be?
Expert:  Dr. David replied 3 years ago.
I'm glad that your testing came out well.

xrays of the pelvis will show bowel gas in front or behind the bladder. the dark brown circles could be air or stool in bowels which are in front of or behind the bladder.
Expert:  Dr. David replied 3 years ago.
let me know if you have other questions.

if done for now, please click accept and leave positive feedback below the chat box so I can get credit for helping you today

you can always reach me with "a question for Dr. David" if you have any other questions

Thanks for using JustAnswers.com
Customer: replied 3 years ago.

Yes but these appear as dark brown circles right where the bladder is so I don't know if they are air or gas or stool, but they are rigth where the bladder is and are sort of spread out in different locations. I am not an expert and don't know how to read x rays but I just wanted an opinion
Expert:  Dr. David replied 3 years ago.
yes, I am an expert in reading xrays which are a 2 dimentional image of a 3 dimentional person. I am giving you my expert opinion.

and I am saying that there can be loops of bowel which can drop in front or behind the bladder and make it look like there is gas or stool or air in the bladder, but there isn't

the ultrasound of the liver was normal and that would have shown air or anything in the bladder.

I would be happy to look at the image if you want to upload it.
Customer: replied 3 years ago.

Yes how do I upload the image?
Expert:  Dr. David replied 3 years ago.
here are instructions


type a word in the textbox and highlight it

then select the "chain" icon above the textbox next to the paper clip

this opens a window where you can click next to the text box to select the jpg or pdf file to upload
Customer: replied 3 years ago.

I am typing to you on my fone so I am not actually able to upload the image I only have a photograph of it on my fone.
Expert:  Dr. David replied 3 years ago.
Well let me know when you can upload the image.

Or if you have any other questions
Customer: replied 3 years ago.

Hello Dr David, apologies for
Not replying earlier as I have been away for some time, I had a follow up question which was that I seem to get boils under my armpit often they will appear for 3-5 days then disapear and come back again after about 3 weeks do you know what this could be?
Expert:  Dr. David replied 3 years ago.
These arm pit boils are most likely from clogged sweat glands or infected arm pit hair follicles

Have you tried scrubbing with antibacterial soap?
Customer: replied 3 years ago.

Yes I do that regularly and also have regular showers.
Expert:  Dr. David replied 3 years ago.
then these boils could be from infection or clogged sweat glands or hair follicles

you should show them to your doctor.

you might benefit from using a loofah to exfoliate the skin under the arm pit.

you might to use antibacterial soap

or you might even need a course of antibiotics to help fight off an infection

let me know if you have other questions.

if done for now, please click accept and leave positive feedback below the chat box so I can get credit for helping you today

you can always reach me with "a question for Dr. David" if you have any other questions

Thanks for using JustAnswers.com
Customer: replied 3 years ago.

Yes the boil has gone now and I have not had any for some time I think it may have been hair follicles as I often shave my arm pits.
Expert:  Dr. David replied 3 years ago.
yes, that was my diagnosis as well.

let me know if you have other questions.

if done for now, please click accept and leave positive feedback below the chat box so I can get credit for helping you today

you can always reach me with "a question for Dr. David" if you have any other questions

Thanks for using JustAnswers.com

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