No Visible Blood In Urine. RBC Found In Urine Test. Any Suggestion?

Posted on Sat, 29 Dec 2012

Question: My friend had a 2+ rbc count in her urine. She was told it was from a uterine fibroid. She has had no visible blood in the urine. How would that work?

Answered by Dr. Das Arindam (20 minutes later)

Hello,
Thank you for posting a query.

Firstly, one point should be cleared. In urine, red blood cells are told as –RBCs /high power field. And presence of hemoglobin in urine is told as 1+/2+/3+. So, 2+ rbc is not possible.

Now, in case of uterine fibroid, she may experience bleeding per vagina. When she gave the urine, the blood got mixed with urine and gave the false result. It is most common thing in our clinical practice. But, from just testing urine, one cannot say that the RBCs are from uterine fibroid. It is impractical rather impossible.

If there is no bleeding per vagina, but still the report indicates presence of RBC or blood detected by chemical methods, then she has to repeat the test. This time she should be cautious about the contamination of blood per vagina with urine.

Lastly, repeat the test again, if she do not have any bleeding.

Hope this information suffices. Let me know, if you have any more question.

Regards.

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

Follow up: Dr. Das Arindam (2 hours later)

So, would a 2+ hemoglobin indicate the same thing? I guess my brain can't figure this out. Does the type of microscope used break down the rbc to show hemoglobin? Also, in other scenarios, would occult blood in the urine come as a result of kidney problems? Thanks.

Answered by Dr. Das Arindam (4 hours later)

Hello,

Thank you for writing back.

If it is occult blood, then there are many possibilities ranging from infection of urinary tract to kidney disease. But, it does not indicates a fibroid in uterus. So, it indicates no definite disease condition but can be seen in many conditions. So, it is to be correlated clinically. You need to visit a nephrologist.

But, if there are both rbc and hemoglobin, then the possibility is contamination of bleeding per vaginum and urine.

So, the two conditions are different.

Consult with your treating doctor for clinical correlation.

Type of microscope used cannot breakdown the rbcs in hemoglobin.

Regards.

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