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Ask Dr. D. Love Your Own Question

Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 17525
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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Need help with urine test results

Customer Question

need help with urine test results
Submitted: 11 months ago.
Category: Medical
Expert:  Dr. D. Love replied 11 months ago.
Hello from JustAnswer.What test results do you need help with?
Customer: replied 11 months ago.
Hi i have been having trouble with very bad pain in my bladder and back for over 2 weeks first of they said urine infection because of wbc and red present ! then when I went back they said not infection just RBC plus plus present, on third time of seeing the doctor they did more urine tests sent them of and came back with
dip test plus RBC again
Lab test
WBC (normal10/mm3) 14/mm3
RBC(normal10/mm3) 18/mm3
Epithelial cells 54/mm3 suggests significant contaminationnot suggestive of a utiBloods test showed serum creatinine level(xe2q5) 90umol/l(45.0-84.0) above high reference limit )
the doctors are saying no further action but why am i still in so much painmany thanks
Expert:  Dr. D. Love replied 11 months ago.
Do you have the original urine test results?Were you prescribed antibiotics?If so, were you still taking antibiotics when this urine specimen was collected or shortly before the urine was collected?
Customer: replied 11 months ago.
i was but finished them over a week before these tests where done
Customer: replied 11 months ago.
only just the original test results showed plus plus RBC and that the lab didn't grow anything
Expert:  Dr. D. Love replied 11 months ago.
Thank you for the additional information. There are a couple of possibilities to consider in this situation. Since the original test did not grow anything, that is more definitive evidence that there was never an infection. The rapid urinalysis, both dipstick and microscopic examination, can give fairly good presumptive evidence of infection, but the culture is the gold standard for diagnosing an infection. Unfortunately, it takes at least a couple days for the culture to return, so the initial decision of whether to prescribe can only be based on symptoms, findings on examination, and the urinalysis. It is also true that they are correct that the number of epithelial cells indicates significant contamination, so also makes interpretation of the remaining findings difficult. If the original urinalysis also had significant contamination, then the other findings in the original test may also be difficult to interpret. However, n the setting of lower abdominal and back pain with blood in the urine, with or without pus, and a negative culture, the primary concerns are either a kidney stone or an inflammatory condition.If the pain is more severe, then a kidney stone would be more likely. The usual next step when considering whether a kidney stone is present would be an imaging test. Plain x-rays can help to a certain extent, but it more often requires advanced imaging, such as an ultrasound or CT scan. Since you do not mention any imaging tests, does that mean that no imaging test has been done?
Customer: replied 11 months ago.
no they said they didn't think anything further would need to be done and this would go away eventually
Customer: replied 11 months ago.
however I'm still in pain and its getting no better
Customer: replied 11 months ago.
i also have pain in my legs and very restless legs at night could this be connected
Expert:  Dr. D. Love replied 11 months ago.
If you were having mild pain, it would be common to say to give it some time to see if it were to ease with time. But since you describe the pain as very bad pain, I would usually be oriented more towards performing further evaluation. It may be worth seeking a second opinion, such as in an Urgent Care Center or Walk-In Clinic. Any cause of pain in the lower abdomen can sometimes cause pain that radiates down into the legs. Restless legs can be a non-specific response to pain, although it also could be related to low hydration status. The mildly elevated serum creatinine is often related to kidney/urinary problems, but it also can be elevated due to low hydration status, even if not overtly hydrated. It may hep to be drinking extra fluids to assure hydration. If I can provide any additional information, please let me know.

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