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QUESTION: Good Morning doctor:

I had a question regarding bubbles in my urine. Should I be concerned with that at all. I have a had a few blood tests recently with a urinalysis that showed nothing. I am having another blood test in 2 months for the following: HbA1C, Creatinine (eGFR), CK, RR, ANA, and Glcose, fasting. I am assuming the doctor is looking for kidney issues, or checking if the kidney is working OK. Can you give me any other concerns that I may have with bubbles in my urine, thanks.

ANSWER: Joe:

Bubbles in the urine could suggest something called pneumaturia which means air in the urine.  Inside the body, there is only one place to get any gas or air and that's the bowel.  This suggests that persistent air in the urine could mean a fistula (abnormal connection) between the bowel and bladder.  This typically occurs in people with bowel problems such as diverticulitis and colitis.  It is also usually associated with urinary infections.  This does not sound like your problem with all of the tests being normal, but it should be checked by a physician.  Blood tests are not likely to help.

---------- FOLLOW-UP ----------

QUESTION: Hi Doctor:

Thanks for the quick response. Firstly, I don't have any problems like diverticulitis and colitis, ever. Definitely don't have urinary infections problems, ever. The only other problem that I have had recently is slight constipation. Would that be a problem? When you say abnormal connection between the bowel and bladder, what do you mean?  I have had a few colonoscopy tests, never showed anything with these test.

Please note that I had a urinalysis test recently, would that not show the doctor anything else? There was no mention of anything bad with the urine  

The doctor is looking for some kidney issues as well with these blood tests for protein in the blood, or urine etc.

Answer
Joe:

An abnormal connection between the bowel and bladder that would allow some bowel gas to get into the urinary system is called a colovesical fistula.  This is usually associated with bowel problems like colitis and UTIs which you don't have.

It is unlikely that the blood tests will show anything to clarify where air or gas in the urine is coming from.  

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Stephen W. Leslie, MD

Expertise

Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.

Experience

Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

Organizations
American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Publications
Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Education/Credentials
Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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