Hello, The probable cause of your symptoms can be the following as per your history you have provided: Severe cystitis / Stone in the urinary bladder / Severe UTI. The urge, pressure, burning, cramp and even the stringy blood clot can be explained by any of the suggested diagnosis. The dark / coffee color of the urine can be altered blood color in the urine on disintegration. There is already a history of bladder infection in the past. This is in fact urinary tract infection of the whole urinary system and the previous infection can form a nidus on which small stones can develop. I can understand the plight you may be going through with all expected yes and nos in your mind. The best way is to get an exact diagnosis so that the treatment can be targeted well; I would suggest the following: First of all, to give urine for tests before the antibiotic are started as even a single dose of an antibiotic can change the real picture. Urine- routine, microscopy, culture and sensitivity. Blood tests: CBC to see WBC count whether increased or not; urea, creatinine, sugar. Ultrasonography (USG): will help in detailed diagnosis, of kidneys, ureters and urinary bladder/stones/infection. The treatment can be started with the consultation of your Doctor - antibiotics the moment urine sample is given, Urilizer ( urinary alkalinize), symptomatic and supportive as needed. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Ivan R. Rommstein, General Surgeon