Lower abdominal & pelvic hip pain, tired &microscopic blood in urine

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Hi any advice please? I've had lower abdominal pain for about 3 months which has got gradually worse, it's in my pelvic/hip bone and I feel constantly tired, especially when I try to do normal every day stuff like walking the dog, housework, pegging out washing. Doctor referred me after finding microscopic blood in my urine over two weeks/3 tests. I've got my first consultation with the Urologist tomorrow. Has anyone else had these symptoms? Thanks

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    You definitely need to look at the number of red blood cells counted per ml or per high power field under microscope

    (or was 'only' the blood colour hemoglobin found? Cells burst?)

    A certain number of red blood cells in urine is found within a range in everyone,

    but in little numbers,

    mostly swept in with glomerular filtration, the problem: how concentrated was the urine. You can imagine the more diluted/drank, the less red cells show up due to concentration. The less drunk, the higher indirectly the concentration. Hence you will find different normal ranges worldwide.

    Anyway as a rule of thumb:

    about up to 3 erythrocytes (RBC) per HPF (high power field under microscope) are normal

    or

    under 12x10^6/L red blood cells (RBC), more or less.

    Anything seen more, will be called 'hematuria' (microscopic hematuria if the urine itself does not look reddish, macroscopic hematuria when the urine is blood red and not due to some eaten food dye) and the search for a reason started.

    (contamination of urine with e.g. menstruation or outside wounds/trauma of tissue have to be excluded!, sometimes a catheter urine is taken for that reason, to avoid contamination and wrong interpretation.).

    usually the morphology of the in urine found red blood cells is looked at as a next step, which gives a hint, where those RBC come from more or less:

    RBCs are more 'deformed' (dysmorphic) the higher up they came from like being squeezed through the kidney filter/glomerula or something happening in the kidney tissue. 

    The RBC contain their shape better (uniform), if they get into urine after kidney (like in a bladder infection, maybe even kidney stone sratch)

    When I had a full blown bacterial urinary tract infection, my urine was blood red, macroscopic hematuria and no contamination blood at all. Like weeing blood. A case for antibiotics and the urologist.

    Microscopic hematuria can therefore be a case for nephrologist, too, depending where they came from most likely.

    So next step: if not done yet: morphology of RBC in urine.

    Best of luck!

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    • Posted

      PS: be aware though (and labs usually are): that if the RBC count is just boarderline above 'normal' range, that a 'most dysmorphic' result says nothing about a kidney disease yet, because the 'normal' range RBC are actually from the glomerula filtration. If you are double over the normal RBC count for example and a half half distribuition is found, one still quite doesn't know if it was in the kidneys or lower. I hope your count and morphology can give undoubtful clues as where they came from in too high (not normal) numbers, as the normal numbers will of course still show up additionally too. There are other urine sediment items (like casts) that an eye will be put onto, too and be helpful in investigation. I did urine screening for years and it is not that plain straight forward, but sometimes it is. Hopefully it is for you!!! All the best

       

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