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Hello, I Have Blood In My Urine ( Hematuria )

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Posted on Thu, 18 Oct 2018
Question: Hello, I have blood in my urine (hematuria) and I saw a Urologist PA yesterday and they want to do a cystoscopy, however, they were unable to schedule me until mid November. Is this something I should go to the ER for or just wait until November.
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Answered by Dr. Dr.Arnab (2 hours later)
Brief Answer:
please see the detailed answer below...

Detailed Answer:
Hello there,
Welcome to 'Ask A Doctor' service...
I've gone through your query in details...

Well, since the urologist has checked already, I believe they must've ascertained the gravity/intensity of the hematuria (I suppose it's not XXXXXXX blood/extremely bright red, please let me know if otherwise)...

Mild hematuria can be given some time after medications and supportive measures (by certain antithrombic medications as well as the bladder wash) and cystoscopy can be planned accordingly (as you've asked).

However, even in the case of waiting, certain other investigations should be done as a priority and part of baseline assessments namely: a Hemogram, LFT, KFT, Urine culture and sensitivity as well as PT/INR, aPTT, followed by a USG KUB.

If hematuria is mild and resolving; HgB level is around 14-15mg/dl, then it can wait for the next few days (however, midway till November is still pretty prolonged, the best timeframe would be somewhere between the First week of October).

Now, in ER, cystoscopy won't be facilitated, even in case of heavy and prolonged hematuria, they'll run those other investigations, supportive measures and give the referral to the Urologist only. Emergency Cystoscopy is quite rare unless there's any obvious evidence of heavy bleeding (like trauma, bleeding tumor or sudden inability to pass urine).

So, in my opinion, perhaps insist on pushing the date a bit earlier, or seek another opinion of a different Urologist at another institute to get the cystoscopy done earlier.

Let me know if I can assist you further.

Take Care
Kind Regards
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Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Answered by
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Dr. Dr.Arnab

Critical Care Specialist

Practicing since :2012

Answered : 1477 Questions

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Hello, I Have Blood In My Urine ( Hematuria )

Brief Answer: please see the detailed answer below... Detailed Answer: Hello there, Welcome to 'Ask A Doctor' service... I've gone through your query in details... Well, since the urologist has checked already, I believe they must've ascertained the gravity/intensity of the hematuria (I suppose it's not XXXXXXX blood/extremely bright red, please let me know if otherwise)... Mild hematuria can be given some time after medications and supportive measures (by certain antithrombic medications as well as the bladder wash) and cystoscopy can be planned accordingly (as you've asked). However, even in the case of waiting, certain other investigations should be done as a priority and part of baseline assessments namely: a Hemogram, LFT, KFT, Urine culture and sensitivity as well as PT/INR, aPTT, followed by a USG KUB. If hematuria is mild and resolving; HgB level is around 14-15mg/dl, then it can wait for the next few days (however, midway till November is still pretty prolonged, the best timeframe would be somewhere between the First week of October). Now, in ER, cystoscopy won't be facilitated, even in case of heavy and prolonged hematuria, they'll run those other investigations, supportive measures and give the referral to the Urologist only. Emergency Cystoscopy is quite rare unless there's any obvious evidence of heavy bleeding (like trauma, bleeding tumor or sudden inability to pass urine). So, in my opinion, perhaps insist on pushing the date a bit earlier, or seek another opinion of a different Urologist at another institute to get the cystoscopy done earlier. Let me know if I can assist you further. Take Care Kind Regards