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  • What to expect after DELAY to get the cystoscopy??

    Posted by apacheco514 on March 22, 2015 at 12:42 am

    My husband, age 68, goes to the VA for medical care. Saw a new Primary Care Physician after his PA retired. Unfortunately, it seems the former PA did not think that the microscopic hematuria was anything to look into. He did not mention it at all. The new PCP said “your last 3 urine tests showed microscopic hematuria” (that was over an 18 month span of time)!! Now that I have access online to his tests (with husband’s approval), I see them all marked High for hematuria. Had I seen that before now, I would have been all over the PA to get him properly tested sooner.

    The Ultrasound 7/14:

    FINDINGS: No kidney, ureteral, or bladder stone. No kidney,
    ureteral, or bladder lesion identified. Post prostatectomy
    changes.

    Coronary artery calcifications. No pericardial or pleural
    effusion. Bibasilar atelectasis.

    Tiny cyst in the right dome of the liver. Adrenal glands, spleen,
    gallbladder and pancreas appear normal.

    Lower portion of the descending colon medialized from typical
    location. Appendix slightly larger in caliber than normal but
    without inflammatory changes to suggest acute appendicitis.
    Scattered colonic diverticula.

    Diffuse atherosclerotic calcifications of the abdominal aorta and
    the common iliac arteries. Otherwise scattered vascular
    calcifications.

    Degenerative changes of the spine. No suspicious bony lesions
    identified.

    IMPRESSION: No kidney, ureteral, bladder stone or lesion identified

    CT IVP 03/15

    FINDINGS: No kidney, ureteral, or bladder stone. No kidney,
    ureteral, or bladder lesion identified. Post prostatectomy
    changes.

    Coronary artery calcifications. No pericardial or pleural
    effusion. Bibasilar atelectasis.

    Tiny cyst in the right dome of the liver. Adrenal glands, spleen,
    gallbladder and pancreas appear normal.

    Lower portion of the descending colon medialized from typical
    location. Appendix slightly larger in caliber than normal but
    without inflammatory changes to suggest acute appendicitis.
    Scattered colonic diverticula.

    Diffuse atherosclerotic calcifications of the abdominal aorta and
    the common iliac arteries. Otherwise scattered vascular
    calcifications.

    Degenerative changes of the spine. No suspicious bony lesions
    identified.

    No kidney, ureteral, bladder stone or lesion identified

    The U/S and CT IVP seem benign, however, now concerned as the microscopic hematuria do I trust them?

    From what I read, if microscopic hematuria is present at all, the cystoscopy should be requested. At least done on the 2nd time. Now it has been 18 months and 3rd positive hematuria. At the very least, my concern should he have had superficial bladder cancer, how fast could it grow in 18 months? Also, what questions should I be asking after the results of the urine cytology results if negative before the cystoscopy? I have lost trust since it seems that protocol has not been followed. He had his prostate removed in 2006 after cancer diagnosed. It was noted as encapsulated and no further treatment required.

    Appreciate some wisdom and comfort and how best to be my husband’s advocate. Thank you.

    ADDITIONAL INFORMATION: My husband worked on auto restoration for over 30 years in his garage using chemicals with basic mask but when painting or sanding a vehicle, the air was not properly ventilated and he continued to breathe the fumes for hours.

    Alan replied 9 years, 8 months ago 2 Members · 1 Reply
  • 1 Reply
  • Alan

    Member
    March 22, 2015 at 1:18 am

    First, none of us are doctors so take any post for what it is worth. Having an ultra sound and CT scan it appears that you have had the normal battery of tests. However, because of the continuing hematuria a cystoscope I would think is a logical test and/or a retrograde pylogram. The scope can see your bladder the latter would go up the ureters and kidneys and thus more invasive. You would have the second under anesthesia.

    Ironically, my wife had microscopic hematuria and we never found out why, almost 25 years ago. We surmised a passed stone, nicked lining from a stone, an unusual infection were all suspected in my wife’s situation but the hematuria passed after a few weeks. On top of that I know a few others that have microscopic hematuria with no known cause infrequently!

    Good luck!


    DX 5/6/2008 TAG3 papillary tumor .5 CM in size. 2 TURBS followed by 6 instillations of BCG weekly with a second round of 6 after a 6 week wait.

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