Coping With Hematuria

I am 71 year old male and am a retired veterinarian (i.e. I have some medical knowledge). Two years (2006)ago I had symptoms and went to an emergency clinic at my HMO. My sumptoms at that time were massive tomato juice colored hematuria (5-6 times an hour) with multiple blood clots (1-2 centimeters diameter, an extreme urgency to urinate, but only in small quantities of 2-3 tablespoons full at a time. There were extremely painful urethral spasms causing me to try and pump out urine by abdominal contraction. There was no pain anyplace excepting for the stinging/burning pain in my urethra.

The pain was so strong that it made driving dangerous because of involuntary leg spasms.[see NOTE below]. My HMO doctor put in an indwelling catheter that led to a urine collection bag on my leg. The HMO emergency doctor put in a tube between the catheter and the bag that was SO SHORT that almost any movement of my leg caused pain because the catheter pulled on the tip of my penis, especailly when the urine bag slid down my leg only a few inches. At home I added length to the tube which significantly reduced the pulling and pain.

A day later the hematuria was diagnosed as prostatitis by a urologist based mostly on a cystography. I was told something by the urologist similar to that there were abnormal blood vessels that could be seen in or at my “prostate”. After several days I improved and became asymptomatic for 2 years until late December in 2008 when the tomato juice colored hematuria reoccured with the same symptoms as above. I again went to the emergency clinic at my HMO. Another catheter was put in, and antibiotic and antispasmotic were prescriberd. About 2 days later the hematuria almost disappeared (yellow colored urine with only a small pink tint of blood) and the urologist removed the catheter in late December 2008. The next day I had a CT scan and some blood work including a culture.

About 2-3 days later, i.e. on new yars eve Dec 31, 2008 the hematuria reoccured with the same symptoms. By 5:30 am on Jan 1, 2009 I returned to the emergency clinic because of increasing pain, spasms and hematuria. I saw a non-urologist MD in the emeregency room who said his diagnosis was “cystitis”. He had a nurse put in another folley catheter (either 16 - 20 french), and I questioned him about if this was not too large for an indewlling catheter and was told it was the preferred size. It turned out to be very painful. After stongly insisting that I wanted to be seen by an urologist he made an appointment for me to be seen the next day by a urolgist. I arrived home at about 10:30. On Jan 1st, I noted that the tube between the cathter and the bag was about 12-15 inches long and had a large loop that went above the level of my bladder so that I had to uninate up-hill. This made uriniting difficult.

At home I significantly shortened the tube so that I could fill the bag by gravity. In the process I aspirated several clots (using a syringe) that had obstructed the tube and the flow. On Jan 2nd I returned to the HMO and saw different urologist, who revomoved the catheter. I asked for a written copy of my CT scan, which discussed multiple renal cysts (2-4 mm) and in one place mentioned a ” undignosed mass” on the right kidney pelvis, then down below it stated that it was on “the left kidney”. It is Jan 2nd at 4:00 pm and I am submitting this as is. I do not know what will happen in the future.

NOTE: One thing that during all of this that I found very helpful was that when I could urinate I did so in a large plastic disposal glass which made my observations much easier, and urination much more comfortable in that it avoided splashing and dripping of blood. This also allowed me to accurately estimate quantities.