[45F] Episodes of Hematuria with Unexplained Weight Loss

Question

Anyone else have similar issues

Patient Description

A 45-year-old female experienced episodes of light red urine, described as hematuria, which occurred a couple of months ago lasting for 7 days, disappeared for 3 weeks, and then reappeared for 5 days. The patient has not noticed it since. There was no pain associated with the hematuria, but blood clots were observed on one occasion. The overall urine color has returned to yellow or amber since the episodes of hematuria ceased. The patient has experienced unexplained weight loss but no other symptoms such as flank pain or fever. The patient's past medical history includes deep vein thrombosis (DVT), pre-diabetes, and pre-hypertension diagnosed about 10 years ago. Current medications include Vitamin D and iron supplements, taken every other day. The patient also mentioned taking a laxative for a few days during the time of the hematuria, receiving the COVID-19 vaccine, and taking a 10-day supply of Medroxyprogesterone Acetate (medroxypr ac) around the same time as the hematuria episodes. There is no known family history of kidney disease or urinary tract conditions, and the patient does not use tobacco products or recreational drugs. Diagnostic tests including a CT scan and cystoscopy were performed but did not reveal any abnormalities.

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Arora's Assessment

What might be happening

Based on the information you provided, the possible causes for your symptoms could include:

  • Urinary Tract Infection (UTI): UTIs can cause blood in the urine, although they are usually also associated with other symptoms such as pain or burning during urination, frequent urination, and lower abdominal pain.

    • Treatment typically involves antibiotics prescribed by a doctor.
  • Kidney Stones: These can cause blood in the urine, but are usually also associated with severe pain in the back or side, and frequent urination.

    • Treatment can range from pain management and drinking lots of water to pass the stone, to medical procedures to remove or break up larger stones.
  • Medication Side Effects: Certain medications, including some over-the-counter drugs and supplements, can cause blood in the urine. In your case, it's possible that the medroxyprogesterone acetate could be related, although this is less likely.

    • Treatment would involve discussing with your doctor whether the benefits of the medication outweigh this side effect, and whether there are any alternative medications you could take.
  • More serious conditions: Blood in the urine can sometimes be a sign of more serious conditions, such as bladder or kidney diseases, or cancer. These conditions are less likely in your case, given your age and the fact that you have no other symptoms, but they cannot be ruled out without further testing.

    • Treatment would depend on the specific condition, but could involve medication, surgery, or other therapies.

What you can do

Given that you've already had a CT scan and cystoscopy which found nothing, it's possible that the cause of your symptoms is not serious. However, you should still follow up with your doctor, especially if you notice the blood in your urine again. They may want to do further testing, or refer you to a specialist for further evaluation.

In the meantime, you can:

  1. Drink plenty of water to help flush out your urinary system.
  2. Avoid any medications or supplements that you think might be causing your symptoms, unless they have been prescribed by your doctor.
  3. Keep a symptom diary, noting any changes in your symptoms, when they occur, and what you were doing or eating at the time. This could help identify any patterns or triggers for your symptoms.

What you should look out for

You should seek immediate medical attention if you:

  • Notice a large amount of blood in your urine, or if the blood is accompanied by clots.
  • Experience pain or burning during urination, frequent urination, or a strong urge to urinate.
  • Have severe pain in your back or side.
  • Develop a fever or chills.

Remember, I'm an AI and this advice is based on the information you've given me. It's always a good idea to consult with a healthcare professional for a formal diagnosis and treatment.

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8 mo ago


People Also Ask


What are the common causes of blood in urine without pain?

Common causes of painless hematuria include urinary tract infections, kidney stones, and sometimes more serious conditions like bladder or kidney diseases. It's important to consult a healthcare professional for a proper diagnosis.


Can medications like Medroxyprogesterone Acetate cause hematuria?

While Medroxyprogesterone Acetate is not commonly associated with hematuria, medications can have unexpected side effects. It's important to discuss any new symptoms with your doctor to determine if the medication could be a contributing factor.


What should I do if I experience blood clots in my urine?

If you notice blood clots in your urine, it's important to seek medical attention promptly. This could indicate a more serious underlying condition that needs to be evaluated by a healthcare professional.


How can unexplained weight loss be related to hematuria?

Unexplained weight loss can sometimes be associated with more serious underlying conditions, including cancers or chronic diseases. If you experience both hematuria and unexplained weight loss, it's crucial to follow up with your doctor for further evaluation.

2 Comments


Sachi#4032

8 mo ago

Not sure if you've gotten a cystoscopy but might be worth doing. And also a kidney ultrasound

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Leo#3962

8 mo ago

Unexplained non-painful blood in urine and explained weight loss probably warrants an assessment from an OB-GYN or primary care provider to rule out an abnormal growth or injury somewhere along your urinary tract. More common explanations could be menstruation or menopause, or a persistent UTI (which also should be treated) but if in the off chance it's cancer always better to catch it early!

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