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Dr. SH
Dr. SH, Board Certified Physician
Category: Medical
Satisfied Customers: 8770
Experience:  Doctor of Medicine
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I need to discuss my problem with an urologist.

Customer Question

hello. i need to discuss my problem with an urologist .My symptoms over 3 months:

-burning and frequent urination
-microscopic blood in urine
-elavated psa ( 1.87 for an age of 36, normal value < 1.4).

-back pain at L5S1, not at kidney regions.

Tests done:
1-) ct scan of urinary tract (1.5 months ago): everything was normal, except 5 mm stone in the left kidney.
the radiologist had an impression of a little bladder wall thickening but was not sure if this is due to an incompletely filled bladder (i went to toilet before ct scan) or due to an organic reason. He was suggesting cystoscopy to be done.

2-) cystoscopy (1.5 months ago): normal

3-) urine cytology (1.5 months ago): negative

4-) MRI for back pain (1.5 month ago) was normal, except minimum bulging at L5 region.

5-) Had SWL (3 weeks ago) one time to break the kidney stone

6-) ultrasound of urinary tract (3 days ago): everything was normal except still 5 mm left kidney stone.

Note 1: in my urine tests, always no infection but almost always crystallization.

Note 2:  When I do  urine tests with dipsticks, the result is non-hemolyzed trace.

Note 3: back-pain and frequent urination problems started  in time

periods close to each other.

Question: What is the reason for my symptoms (burning, frequent urination and microscopic hematuria)?

Can it be bladder cancer?

Submitted: 1 year ago.
Category: Medical
Expert:  Dr. SH replied 1 year ago.
Thank you for your question.Sorry to hear about your problem.Bladder cancer has been definitively ruled out with the tests that you have had done i.e. cystoscopy and CT scan.I think that it could be the 5 mm stone that is causing your microscopic hematuria and not anything serious like cancer.The crystals that you are having in your urine happen normally, particularly in people who have a history of stones in the urinary tract.So, with your normal tests, I would not worry at all.Let me know if you have more questions.Rate me by clicking on one of the stars when you are done asking.Kind regards
Customer: replied 1 year ago.

Dear Dr. I asked my question to an urologist.

Are you an urologist?

This is opposite to what you said:

"Hemolyzed blood is the one which is originating from upper urinary tract {kidneys} while non-hemolyzed blood is from bladder. Hemolysis is breaking of the red blood cells in the blood. This occurs when the blood stays out of the vessels for long {as when its originates at kidneys versus that from bladder}. Though this is a general rule but exceptions are there and further evaluation is needed when this occurs in significant quantity and regularly."

Expert:  Dr. SH replied 1 year ago.
The previous question that you showed me was not answered by a urologist.What I can tell you is that the statement that the previous doctor has mentioned is accurate but does not apply in all cases.Additionally, you have had all sophisticated tests to rule out anything serious.The best test to have a look inside your bladder is cytoscopy which has ruled out anything in the urinary bladder.Although usually hemolyzed blood comes from upper urinary tract but this is not true for all cases.I have had so many patients coming in with non-hemolyzed blood in the urine that turn out to be stones in the urinary tract or in the kidneys.The bot***** *****ne is that you do not have anything serious like cancer or anything to worry about at all whatsoever particularly with the normal tests that you have had. Let me know if you have more questions.Rate me by clicking on one of the stars.Kind regards
Expert:  Dr. SH replied 1 year ago.
Let me know if you have more questions.I would appreciate it if you could rate me by clicking on one of the stars if possible.Kind regards
Customer: replied 1 year ago.

i am afraid that the urologist who did cystoscopy may missed something.

it took 3 minutes.

if it is bladder cancer, why is psa elevated (1.87 for age of 36, normal value <1.4).

if it is only kidney stone, why do i have burning and frequent urination for almost 4 months?

still non-hemolized blood in almost all tests.

I have been to 5 urologists, 5 different opinions.

I have no more respect to medicine and doctors.

Expert:  Dr. SH replied 1 year ago.
The PSA of 1.87 is extremely slightly elevated and not of clinical significance.Trust me, you do not have cancer and it is your anxiety that is getting the better of you as far as I am concerned.Three minutes is enough time to have a look inside the bladder which is a very small organ.With all your tests coming back negative for cancer, I would not worry whatsoever.Let me know if you have more questions.Please rate me by clicking on one of the stars before we proceed as that is the only way I am credited here for helping you out.Kind regards
Customer: replied 1 year ago.

thanks dear dr,

i afraid that the urologist may missed something.

since cystoscopy is an invassive opearion, i do not want to do again.

are you urologogist?

if not, could you share my symptoms and tests with an urologist?

it is 4 months, no improvement.

Expert:  Dr. SH replied 1 year ago.
Can you please rate me before we proceed.Thank you
Dr. SH and 2 other Medical Specialists are ready to help you
Expert:  Dr. SH replied 1 year ago.
Trust me, with the kind of tests that you have had, it is not possible to have missed anything serious.
You can try posting this particular question again in the urology section to get another opinion.
Quite often there is no cause of hematuria found even after extensive tests but the good thing in your case is that all serious causes have been considered and ruled out effectively.
So I would not worry whatsoever.
Kind regards