Kidney Stones

[Guest]

I AM A 39 YEAR OLD WOMAN.I WENT TO MY GP 2 WEEKS AGO WITH LOIN PAIN AND FREQUENCY ON URINATION.I WAS PRESCRIBED ANTIBIOTICS .THE FREQUENCY HAS NOW PASSED BUT I STILL HAVE LOIN PAIN.TWO URINE TESTS SENT TO THE LAB SHOW NEGATIVE.HOWEVER 7 DIPSTICK TESTS HAVE SHOWN++ BLOOD AND THE MOST RECENT + PROTEIN AS WELL.AN ULTRASOUND OF THE KIDNEYS AND X RAY OF THE STOMACH AND BLADDER SHOWED NOTHING.THE DOCTORS CANNOT UNDERSTAND WHY THE DIP STICKS SHOW BLOOD AND THE LAB TESTS DO NOT.
CAN ANYONE WHO MAY HAVE EXPERIENCED THE SAME THING AS THIS PLEASE HELP ME I AM DESPERATE FFOR SOME ANSWERS.THANKS

[Guest]

A dipstick is not always reliable in checking for blood and both an ultrasound and KUB x-ray are also insufficient to be sure.

It sounds like you may have passed a small stone. This would account for the pain and the trace of blood which is intermittent. A microscopic examination of the urine is considered more reliable than the dipstick which is sometimes too sensitive.

You should see a urologist who deals with these problems often. In cases like yours, sometimes the best course is to do a formal IVP (which completely evaluates the kidneys and ureters) and a cystoscopy (a look in the bladder with a telescope) to make absolutely sure there is no current problem. If the results are negative, you can then at least be sure there is no polyp, lesion or tumor. A urine cytology examination should also be done.

Stephen W. Leslie, MD
[quote] I AM A 39 YEAR OLD WOMAN. I WENT TO MY GP 2 WEEKS AGO WITH LOIN PAIN AND FREQUENCY ON URINATION... [/quote]

[Guest]

re your reply thanks so much.The reason I do not want to have an IVP is that I am concerned about a reaction to the dye
there is a history of thyroid problems
in my family.I do not want to undertake
invasive tests when there has been no evidence form the lab to support the result of the dip stick tests.If there are blood cells on the dip stick tests then surely the same sample of urine must produce the same result under microscopic examination??? unless the dip stick tests are not accurate.I agree that cystology urine tests would be a good idea.thanks
[quote] A dipstick is not always reliable in checking for blood and both an ultrasound and KUB x-ray are also insufficient to be sure.

It sounds like you may have passed a small stone... [/quote]

[Guest]

As far as I know there is no connection between thyroid problems and contrast reaction to IVP dye. There are potential problems in patients with some degree of renal failure (creatinine of 2.0 or higher on blood testing) or with a history of prior allergy to IVP dye.

The dipstick does not actually measure blood cells, it just reacts chemically to their presence. As I mentioned earlier, they are not completely reliable and the microscopic analysis does not always agree with the dipstick finding.

You are wasting your time arguing about the test. You should be focused on a persistent loin pain with questionable but persistent evidence of blood in the urine. I think the IVP is appropriate under these circumstances to help give us a better answer rather than quibbling about the relative validity of dipsticks versus microscopic analysis.

Stephen W. Leslie, MD
[quote] re your reply thanks so much. The reason I do not want to have an IVP is that I am concerned about a reaction to the dye
there is a history of thyroid problems
in my family... [/quote]

[Guest]

Bagpuss, I just want to say the same thing happened to me several times. I almost always have a trace of blood on the sticks but the dr. finds nothing with the microscope (except with this recent stone episode). As far as the IVP, if you're fearful of a reaction, I was petrified and had no reaction at all. However, last week I had a cat scan with contrast and did feel a warm feeling in my neck and groin. The technician said "this is normal" as it was happening, and the room was so darn cold, I pretended I was on the beach and in the sun! I wasn't scared at all and went to work afterwards with absolutely no side effects. The only thing they told me is to drink a lot of water to flush it out. I hope this eases your mind a little.

By the way, a normal reaction, which I had is different than an actual allergy to the dye, in which case the facility is prepared to treat it immediately. You might ask them about this beforehand to feel comfortable about going. Good luck, I have just been through the mill with these tests and it is certainly anxiety provoking!
[quote] As far as I know there is no connection between thyroid problems and contrast reaction to IVP dye. There are potential problems in patients with some degree of renal failure (creatinine of 2... [/quote]

[Guest]

While there is always the possibility of a reaction, these are uncommon and the risks must be compared with the risks of having a problem and not being able to identify or diagnose it because we are not using the best available technology.

Stephen W. Leslie, MD
[quote] Bagpuss, I just want to say the same thing happened to me several times. I almost always have a trace of blood on the sticks but the dr... [/quote]

[Guest]

ANNIE 57
Thanks so much for your reassuring reply its so good to know that someone feels like I do about these tests.I admit to being a coward I have also been
in nursing many years ago and have perhaps a little too much knowledge about medical matters which I know can be a dangerous thing.I am petrified of having a reaction to the dye and that the staff will not know how to deal with it!!Also I do not want to take the
risk of having such tests done when there is no conclusive evidence other than my dip stick analysis and loin pain which may or may not be normal back pain.The problem with all this is that it seems to be all ifs and buts!!
I do hope you are able to sort your problems out soon.thanks a million Bagpuss.
[quote] Bagpuss, I just want to say the same thing happened to me several times. I almost always have a trace of blood on the sticks but the dr... [/quote]

[Guest]

Thanks so much again for your reply. I take on board all your comments and I do agree that the technology we have today is a good thing.However I am still
not convinced that taking risks such as
an IVP at this stage is necessarily a good thing.I would like to have kidney blood tests,urine cytology and possibly more urine tests over the next few weeks before having an IVP.I will be seeing my urologist thursday this week to have another chat about things.I will give serious consideration to your very valid comments and I appreciate all your helpful advice.
ps in case you are wondering I am e mailing from London,England and yes it is raining here as always!!!
[quote] While there is always the possibility of a reaction, these are uncommon and the risks must be compared with the risks of having a problem and not being able to identify or diagnose it because we are not using the best available technology.

Stephen W... [/quote]

[Guest]

It's your decision and you have the facts. Abdominal pain with persistent microscopic hematuria requires an examination of the bladder interior, ureters and kidney interior. This is usually done with a cystoscopy exam of the bladder, urine cytology studies and an IVP or similar test. None of the other tests you mention can adequately take the place of the IVP and sequential urine and kidney tests that you mention cannot be considered an adequate substitute.

However, this is another possibility. We can do bilateral retrograde pyelograms. This requires a scope to be placed into the bladder and a small tube used to inject contrast directly into the ureter. The entire lining of the ureters and kidneys shows up very well, even better than with the IVP.

We don't do this regularly because it requires more time, is a more invasive procedure and has to be done in the operating room, usually with sedation. It is quite safe from the point of view that no contrast enters the bloodstream. This technique is usually reserved for patients who are very allergic to the contrast who can safely undergo this procedure.

Stephen W. Leslie, MD
[quote] Thanks so much again for your reply. I take on board all your comments and I do agree that the technology we have today is a good thing... [/quote]

[sammi1]

I have been dealing with the same since Feb. However I also have a cyst in my overy. So they are not sure if that is causing the pain. I did just see a urologist and his test shows no blood in the urine. But he is scheduling me for the cystoscopy bilateral retrograde. I am a bit nervous with all the reports of people feeling pain when they are under anastesia and such with that. They dye is a bit unnerving, but I have had it with a brain scan. I am a bit frustrated with no one knowing what is causing the blood but yet they say it is not something they can just let go...So as the bills go up I at times feel like I am losing my mind. I am hoping that getting the cyst in the overy drained with solve some issues and narrow this all down. I will check back and see if anyone else has any updated and I will let you all know how things go,,,,