Brief Answer:
I think you need an evaluation of your urinary tract for source of bleeding

Detailed Answer:
First I want to make sure that you are postmenopausal and no longer having periods?

The source of the bleeding is either urinary tract (kidneys, ureters, bladder, or urethra), reproductive, or gastrointestinal.

Assuming the bleeding happens when you urinate and is not increased when you defecate (and there is no blood on the tissue when you wipe your behind), I would think gastrointestinal causes are less likely.

Gynecological causes are possible. Blood can be passed from the vagina when you urinate, but likely you would see some blood on your underwear when you haven't just urinated.

The most likely cause is that the blood is coming from somewhere in the urinary tract. Causes include stones anywhere along the tract, inflammation, and possibly tumors (benign or malignant). Bleeding without an infection requires a work-up for the cause. You need to follow-up with your doctor for further evaluation.

The first step is a compete microscopic urinalysis. I don't know if your doctor sent your urine specimen to the lab for complete microscopic urinalysis or if she just sent if for culture to see if there is an infection. Or she may have just done a "dip stick" eval in the office for presence of signs of infection. So a "complete urinalysis with microscopy" is in order and would be the starting point of the evaluation. Depending on what the microscopic evaluation shows, next would be imaging studies of the urinary tract.

I would advise one other thing: please call the pharmacist where you get your medications filled and ask to speak directly with the pharmacist. Request that he or she run a search on your meds to see if any of them are associated with hematuria. Pharmacists are almost always willing to do this if you suggest that they call you back with the info at a time that is convenient for them.

Please let me know if I can provide further information or clarification.

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Brief Answer:
If you are in a great deal of pain, you would do best to go to the ER.

Detailed Answer:
Either Tylenol or Advil are fairly equal - Advil is better for inflammation.

But I think you should be seen promptly if you are having that much pain on top of the bleeding. Please don't wait.

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Brief Answer:
I hope you are able to get the cause identified quickly.

Detailed Answer:
In addition to the complete microscopic urinalysis, additional tests to get initially include a CBC, BUN, and Creatinine blood tests. They may also want to do some autoantibody tests. And then imaging studies.

Your welcome and I hope you are better soon.

Bonnie Berger-Durnbaugh, MD

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