What Do These Hemogram And Urine Analysis Report Indicate?

Posted on Mon, 28 Dec 2015

Question: Around 2nd week of October, I had extreme sexual arousals many times without having sex/ ejaculation. The only change in my diet during that time was to have green tea for a month long. In that week, after sexual intercourse I had bleeding first time while urinating afterwards with a clot. At that time I did not have ejaculation (I do not have in general any problems in ejaculation. Only thing was that I skipped having the same during that period). It started bleeding with clots after having intercourse / masturbation. I have reduced my sexual activity since that. Bleeding does not happen every time. I have observed that if the excitement level is low during sex, it doesn’t bleed, but sometimes the bleeding with clot occurs after getting more excited even without ejaculation. I have referred this to my family doctor. He diagnosed that as HAEMATURIA. He has given me the course of medicines on kidney stones (Stonex and Cystone). I have also got sonography (Abdomen / Pelvis and Scrotum) done on his recommendation. Sonography report is normal except following two observations : 1. Mild Mucosal irregularity in Urinary bladder 2. Mild changes of cystitis. No other significant abnormality observed. I had a course of antibiotics CEFTAS-200 tablets. I have also got Haemogram and Urine (Sample with blood) analyzed. Haemogram is normal. The only abnormalities in urine report for 10 ml sample are as follows: 1. Proteins: Present 2. RBC: 35-40 /hpf I frequently experienced mild pain in Testis and lower abdomen in last month. Please advice.

Answered by Dr. Dr. Ashok Kumar Choudhary (1 hour later)

Brief Answer:
This seems due to cystitis but need further evaluation

Detailed Answer:
Dear XXXXXXX
Thanks for using Healthcaremagic.

I read your query and understand your concerns.

Having spontaneous sexual arousal is normal any person for healthy men and I do not think it has much significance. The only explanation could be possible nerve irritation leading to difficulty in ejaculation.

The hematuria is common symptoms of cystitis. Since it responds to antibiotics I will advice you to continue medication for at least 10 days preferably 14 days.

In regard to mucosal abnormality in bladder I like to proceed for cystoscopy in case it do not resolve in two weeks of antibiotics and your age is above 50 years.

There is high chance of bladder carcinoma presenting with similar symptoms mostly after the age of 50 years.

In case both of the above criteria meets for you please see a urologist as soon as possible to get cystoscopy done. If the age criteria do not apply for you but still you are experiencing symptoms it indicates that your antibiotic was not effective for you and that can be handled by changing antibiotic after getting urine culture and sensitivity.

I hope this assists you in dealing with hematuria.
Thanks and regards

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

Follow up: Dr. Dr. Ashok Kumar Choudhary (11 hours later)

Though the diagnosis done by family doctor is hematuria, I feel this as hematospermia as this is taking place only during sexual arousal.
You have talked about antibiotics ,which antibiotics you recommend?
What is the reason for light pain in testis and lower abdomen?
I have referred blogs on your site in which many such cases were discussed under hematospermia by Dr.XXXX XXXXXXX

Answered by Dr. Dr. Ashok Kumar Choudhary (3 hours later)

Brief Answer:
evidence is more indicative of hematuria

Detailed Answer:
Dear XXXXXXX
Thanks for reverting back to me.

I think hematuria is right diagnosis as there are enough rbc in urine examination to call it hematuria. Normally there is only 1 to 2 rbc per hpf of urine examination and anything above 20 is hematuria. In addition there is evidence of cystitis in sonography report.

The lower abdominal pain and testicular pain can be caused by cystitis which is underlying cause for hematuria.

As I said earlier there is need of urine culture and sensitivity testing to determine right antibiotic for you in case problem continues.

Hematospermazia is blood in semen not blood in urine.

I hope this clears it altogether.
Thanks again.

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Above answer was peer-reviewed by : Dr. Raju A.T