Thanks for your question. If I don't respond to you immediately, it is because I am either in the OR or traveling. I WILL get back to you ASAP.

If you had bladder cancer, you can be completely free of blood at times with no microscopic blood present. You cannot rule in or rule out the presence of bladder cancer just by the pattern of bleeding you may have. Based on your young age, I don't think you should be overly concerned that you may have bladder cancer. But you still do need the evaluation regardless of your insurance status. This is your life you are dealing with and just ignoring this episode could potentially let the small risk of a bladder cancer grow undetected. This could be due to kidney disease such as thin membrane disease (which is not hereditary), but the only way to find out is to have a doctor evaluate you. You need a CT scan and cystoscopy to rule this out. I wish there was another way around this, but I am afraid there it not. Hope this helps.

I've read that with BC you can go weeks without experiencing another episode of gross-hematuria again, however it ALWAYS resurfaces, is this true?- Yes this is true. An untreated bladder tumor can bleed intermittently. Even if the bleeding stops, it always starts to bleed again at some point, but it may not be for months or years when the tumor has had time to grow to a more advanced stage. This is why you can't wait for the next episode of bleeding to occur.

It's been over 6 months since my last episode. Do people who have BC usually experience gross-hematuria again within 6 months or have other symptoms?- People with BC with just have intermittent bleeding and possibly urinary tract infections or urinary urgency.

You commented that "benign familial hematuria" or Thin basement membrane disease is not hereditary, yet every site I look at says that 2/3 of those that have this disease have a family member who has it as well? Please clarify. - There are many types of thin membrane disease, some of which are hereditary and some of which are not. If you have the benign familial type, then this can be hereditary. The only way to find out if you have this hereditary type is to have a kidney biopsy.

And lastly, given they can't find another cause, would I be foolish to only get a cytology and CT scan done, given my age? I've heard horror stories about cystoscopy and would like to avoid that procedure if at all possible... especially since I've heard that cystoscopy still misses up to 20% of tumors and is no guarantee. Is this just something that would be recommended more for liability reasons given my age?-

Yes, it would be foolish to not have the cystoscopy. This is a very benign procedure and the horror stories you hear about are very rare or great exaggerations (I'm not even sure what type of horror stories you read about). Not doing cystoscopy can miss small tumors not detected on CT scan or cytology.

Do people who have BC usually experience gross-hematuria again or have other symptoms within in 6 months of their first episode?- I actually did answer this question above. Here is it again:

It's been over 6 months since my last episode. Do people who have BC usually experience gross-hematuria again within 6 months or have other symptoms?- People with BC with just have intermittent bleeding and possibly urinary tract infections or urinary urgency.

Also, since it was my uncle, could that still be considered a hereditary link to me possibly having one of the benign familial thin membrane diseases?- While it is possible, it would be very unlikely that his disease would have been passed on to your side of the family (unless either of your grandparents had it as well)

Most people will typically have bleeding withing a month of their first episode of bleeding when they have BC

Can the type of gross-hematuria determine the source? I had "total" hematuria, from beginning to end and no clots that I could see.- Sometime, you can guess where the bleeding is coming from based on the pattern of bleeding, but this is not reliable. If you had total hematuria, this is indicative of bleeding from the bladder such as from a bladder tumor.

Lastly, could stones [kidney or bladder] cause painless, gross-hematuria? My urinalysis showed that my proteins were normal [along with everything else].- Yes, stones can cause painless gross hematuria if they are not causing blockage to the kidney

I've read that people usually experience "total" or "terminal" that have BC... is one more common than the other? - No, one is not more common than the other.

I've also heard that besides the bladder, total hematuria also typically indicates the upper urinary tract, is this true?- yes, this is true

Yes, most people have cystoscopy done due to hematuria. This procedure does not lead to incontinence or painful urination. Your grandfather had other issues going on as the cause of these problems and it was not from the cystoscopy.