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Hi, I M Following Up On Microhematuria And Would Prefer

Posted on Sat, 27 Apr 2019

Question: Hi,
I'm following up on microhematuria and would prefer mri to ct because I've had multiple (10) ct's for 17 lung nodules and have an EFGR between 60-90. I also have been taking hbp meds fopr 35 yrs. I'm concerned about radiation and contrast nephropathy. What argument would you present to my insurance company that rejected mri and I'm appealing? The local hospital has a tesla 3 machine and they do mri urology. Thanks for all you do! XXXXXXX XXXXXXX

Answered by Dr. Dr. P. T. Patil (52 minutes later)

Brief Answer:
I would advise not to get MRI for microhematuria

Detailed Answer:
Hello
Thanks for query .

In view of normal PSA and normal CT done in XXXXXXX 2018 I would say there is no rationale for doing MRI .MI is advised only in a situation when concerned Urologist suspects localized cancer of prostate based on digital rectal examination (DRE )or PSA is above 4

The microhematuria is very commn finding reveled on routine urine analysis and can be due to mild UTI or Benign Enlargement of Prostate (BEP) which is very common at this age and can be treated with appropriate antibiotics and medications

Let your Urologist decide regarding need for doing MRI. .

Get your routine urine test and urine culture done so as to take appropriate antibiotic .

In the mean time you can start taking Take broad spectrum antibiotics like Cefixime along with urinary antiseptic like
Nitrofurantoin twice daily and urine alkaliser thrice daily.Later on switch on to appropriate antibiotics as per culture report.

Hope I have answered your query ,please feel free to ask if you have more questions,I shall be happy to help you
Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. P. T. Patil (59 minutes later)

Thank you! My recent ual's show much higher jrbc's (10-25) and since my son had clear cell kidney cancer, and I'm an exsmoker who was exposed to benzene and hydrocarbons as well as 25 years of hypertension my doctor approved the mri but insurance wants me to do ct which I'm opposed to because of my 10+ ct scans for 17 lung nodules. Would an mri be harmful and if not would any of my concerns be reasonable for appeal to my insurance company? Thanks again! XXXXXXX

Answered by Dr. Dr. P. T. Patil (20 hours later)

Brief Answer:
MRI is advised only when C T finding are inconclusive

Detailed Answer:
Hello
Thanks for writing again .

I would be glad to know whether MRI is advised by your family physician or Urologist .

Normally MRI is advised in a situation when C T findings are inconclusive or more precise information is required to decide line of treatment.

The risk that you are worried about radiation hazards in doing contrast CT scan is due to anxiety and under normal circumstances does not cause radiation nephropathy as feared by you .

Finally it is the the discretion of insurance company to sanction MRI or not .

Thanks and Regards.
Dr Patil.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar