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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 17329
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I am a 35 almost 36 year old female. I have had a few

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Hi, I am a 35 almost 36 year old female. I have had a few previous surgeries (partial hysterectomy - uterus and cervix removal). These were both completed a few years ago due to adnometriosis. I never went back for my 3 month visit and previously did have a cyst on my ovary. The only reason I'm going into that much detail is because I just wanted to give a little background. I have now the previous month been back to the doctor twice. I have had two rounds (a few days each) of urinating blood and mucus/tissue. And have now yesterday started to have it happen again. I have had other symptoms the past few months that I've been ignoring and just trying to cope with... I'm not a fan of the doctors office and lack health insurance. The first visit I was diagnosed with a UTI sent home with Macrobid (maybe wrong spelling) and called a few days later to also be told I had food poisoning. The lab tech reiterated on the phone to go to a regular doctor if the issues I was having weren't getting better. My indigestion/ heartburn / lack of appetite were a little less and the bleeding stopped so of course I said who needs to go back. Two weeks later I started bleeding again. It was 4th of July weekend and I was out of town. It lasted a day longer than previously and was slightly more uncomfortable beings I had to live by the toilet the entire day with really just a feeling of having to go with a result of tissue coming out or thick mucus.. (I know gross) so I made an appointment with a doctor who proceeded not to take a health history and tell me it was most likely my bowels and wanted to prescribe more antibiotics. I actually refused (a first for me) the help and left her office. I think it was mostly the guessing game she played to me like it could be this and this and maybe this so let's start with antibiotics. I had already been prescribed antibiotics and just was frustrated that she hadn't even asked my history. She actually asked if I had my period at the same time and I know it's not her fault for not knowing but when you make an appointment for something like this you would think that someone would ask my history. I've been reading a lot on how cysts rupture on their own, and am thinking maybe mine finally just burst due to there being no where else to escape is it possible it ended up coming out through my urinary tract somehow? I don't know, I just was looking for some advice, I can make another appointment but I haven't had a regular doctor since I was 20. Do I go in or can I chop it up to most likely that. It seems the last few months I've been uncontrollably bloating, I try to eat and sometimes just feel full after a few bites and can't. I do have good days and bad so it's just a matter of getting through the bad but I've been eating Pepcid AC like its candy and it doesn't really relieve it. I was just worried they are all tied together and don't know what I should really be asking a doctor or asking them to find. Or which doctor to go to... My last appointment was with a family physician. It's a little frustrating sorry if any or all of this is confusing.
Submitted: 3 months ago.
Category: Medical
Expert:  Dr. D. Love replied 3 months ago.

Hello from JustAnswer.

An ovarian cyst that has ruptured would typically not cause any blood, mucus, or tissue in the urine. However, to address other aspects of the situation, it will help if you could provide some further information.

When you were told that you also had food poisoning, were you having any GI symptoms beyond the indigestion/heartburn/loss of appetite?

Do you know what test showed the food poisoning?

Was any treatment provided for the food poisoning?

When you were seen the second time, were you having any bowel symptoms?

Expert:  Dr. D. Love replied 3 months ago.

I had asked for some further information and have not heard back. While I cannot provide as complete an answer without this information, I can make some comments, and explain how the additional information may be helpful.

First, the most common cause of short duration of blood in the urine is a UTI. While there are many other possible causes, it is always appropriate to first consider whether there is evidence of a UTI. And when there is recurrent symptoms, it would be appropriate to consider reasons why the infection may not have cleared up, such as a resistant germ. A urine culture and sensitivity will typically confirm a UTI and detect any rsistant bacteria.

It is unclear what type of food poisoning may have been present, and this is where the additional information that was requested would help the most. Many types of food poisoning do not require specific treatment because most cases will resolve spontaneously. However, treatment may be required if symptoms are more severe or persistent, or in certain types of food poisoning regardless of severity of symptoms. I can say that if you were not started on any additional treatment, the Macrobid would not have helped, as the antibiotic does not achieve levels to be effective until it is concentrated into the urine.

While an ovarian cyst would not cause blood in the urine, even if ruptured, with your history, there is one other consideration that may be causing the cyst and blood in the urine. It is possible that the endometriosis can recur despite the surgery. While a hysterectomy will usually stop the endometriosis, there are some women that can have recurrent endometriosis after a hysterectomy, and the risk of recurrence is greater in women in whom the varies are preserved. Endometrial implants on the ovaries can appear cystic. Endometrial implants can also occur on the urinary system, most often on the bladder.. Most endometrial implants on teh bladder are superficial, but a small percentage can be deeper, and the deeper endometrial implants that can cause blood in the urine. While blood in the urine related to a deep endometrial implant on the bladder is not common, when it does occur, the bleeding can be episodic, just as menstrual bleeding was episodic before the hysterectomy.

So, the first issue would be consideration of whether there is a recurrent UTI, and that is something that can usually be managed by a primary care physician. The additional information that I requested would help clarify the extent of concern about food poisoning and what next steps would be appropriate. If no other cause for the symptoms can be identified, it would be appropriate to see an OBGyn for consideration of whether there is any recurrent endometriosis despite the hysterectomy.

If I can provide any additional information, please let me know.

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