Urology/lab results fear of bladder cancer
I asked a question the other day about uti culture that came back negative ( or maybe contaminated)
even thought all my UTI symptoms resolved quickly with antibiotics. I had trace microscopic blood in my urine however and had to have repeated UAs since then and I wanted help in interperting the results. I do have a uro appt scheduled for 2 weeks from now. However reading about the possibility of bladder cancer when there is blood in the urine has me really freaked out and I need some better understanding of these lab results ( i got the results on line and no doctor avaialble until next week).
Here are my questions:
1. I am trying to understand what a contimated sample means as far as cuture is concerned. My culture was positive for >100000 mixed gram positive organisms which I understand means probable contamination. Does contamination mean negative sample with no possibilty of UTI or does it mean that it is possible I did have a uti but its not possible to tell from the sample? By the way after I described my symptoms to the doctor she stepped out of the room and did what i assume was a dip test and came back and told me that I had an infection and she was going to culture the urine to make sure she is giving me the right antibiotic. The sample was also not a clean catch as I recall not waiting until midstream. I am asking this because I am concerned about the microscopic blood even more if there was no UTI.
2. My second UA came back as a +( not sure what number) on the dip stick for blood and 0-1 wbc and 0-1 RBC.
3. Third test ( at my actual dr office as my UTI was diagnosed at a different local clinic) came back 2+ for blood with 0-6 rbc and 0 wbc as well as bacteria, epithelial cells and mucous strands. This culture was determined to be contaminated so was not cultured and had to give another sample, which I gave 2 days later.
4. Last test was clean and is being cultured now. It showed +1 on dip stick. 0 RBCS and 0 WBC. However, the specific gravity of my urine was low at less than 1.006 and from what I read this might mean that they were not able to see the RBC's even if they were there. I am hoping you can shed some light on these tests. I have practically diagnosed myself with bladder cancer and am feeling really scared as I thought I was just going in for a UTI!!
A contaminated sample means there are too many skin bacteria in the sample to tell if there is a UTI or not. These bacteria are picked up from the skin as the urine flows out. This may come up positive on a dipstick test which is why we hesitate to make diagnoses from the dipstick. If you had symptoms of an infection, then you may have had one but we can't tell from a contaminated specimen.
Your positive dipstick for blood also is questionable when the microscopic test comes back as essentially negative. We consider the microscopic analysis more reliable.
When the urine SG is low, some blood cells may swell or even break open but this is relativel uncommon. Even if the blood cells broke open, the shells would still be visible.
The vast majority of people with borderline microscopic hematuria have no illness and most of the time we don't find any bladder cancers.
If you were my patient, I would put you on a low dose urinary prophylactic regimen and get some catheterized urine specimens (unlikely to be contaminated). If the blood traces in the urine are confirmed, then we would consider looking into it further. However, your urologist will make up his or her own mind about this.