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Dr. Abby
Dr. Abby, Board Certified MD
Category: Health
Satisfied Customers: 10330
Experience:  Family Physician, practicing medicine for over 10 years, United States
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I'm 50, in good health, perimenopausal, recent history of

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Hi, I'm 50, in good health, perimenopausal, recent history of stones (4x in past 2 years) - once 6 weeks ago. Stones have always passed in 24 hours. 10 days ago I suddenly began having urinary urgency and frequency, no pain on voiding. Some relief on voiding but urgency begins 15-30 min later. Noticed a small clot of blood in urine on day 2. Went for urinalysis 3 days layer, results: no WBC, trace bacteria, some blood. No antibiotics were prescribed. Noticed some lower back pain, pain in thighs, pain in abdomen, then more upper back pain which has since dissipated, and today, intermittently the kind of abdominal pain I've had with a stone. Do I need another urinalysis urgently? I have an appointment with my urologist in 4 days.
Submitted: 7 years ago.
Category: Health
Expert:  Dr. Abby replied 7 years ago.

Are you having any fever?
Burning with urination?

Dr Abby
Customer: replied 7 years ago.
Hi, no burning, no fever. I would be sure I had an infection except that tests were negative (although I have been drinking so much water the urine may have been very diluted) and also I don't have a burning sensation when I urinate.
Expert:  Dr. Abby replied 7 years ago.
Thank you,

If you suspect that this is a kidney stone recurrence, doing another urinalysis really isn't going to change anything.

If it shows blood, this would simply indicate that a stone may be present within the urinary tract....and we just wait for you to pass it.
If you are having significant pain and need stronger pain medication than what you currently have at home, then I do recommend that you see your doctor.
Other than that, if you don't have burning with urination or fever, you can probably hold off on an urgent urinalysis.

Please let me know if you have any follow up questions and I will be happy to answer them for you,

Dr Abby

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Customer: replied 7 years ago.
Thank you.
10 days seems like a long time for a stone that is not causing much pain, the others have all passed in 24 hours. I'm not convinced it's a stone, just a suspicion. And where would the stone be located to cause urgency? What is the rate of false negatives with urinalysis? I don't want kidney damage to occur. Of course I'm concerned about something pressing on my bladder, could I have an ovarian cyst? But the clot in my urine makes me believe it is something in the urinary tract. Just my uninformed thoughts.
Expert:  Dr. Abby replied 7 years ago.
You ask good questions.

First, a stone could be present within the bladder, leading to irritative symptoms and blood.
If it were present within the ureter or urethra, I would expect much more pain. Kidney damage will not occur if the stone is within the bladder.

There are false negatives with a urine dipstick. Sending it for urinalysis in the lab along with urine culture decreases this significantly.

As for something pressing on the bladder, that is possible as well. An ovarian cyst would have to be fairly large. More commonly, uterine fibroids can do this. Neither of these woudl cause blood in your urine.

Because you are perimenopausal, vaginal contamination of the urine has to be considered as well. It is possible that the clot was from the vagina, although I think this is less likely given your urinary urgency.

If you have concerns, then have a second urinalysis but make sure it is sent for culture.

You will need to have a CT done by your urologist to look for kidney stones, most likely. If it is negative, he may refer you for further testing.

Let me know if you have further questions,

Dr Abby

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