Blood In Urine: See Specialist Or Go Through Normal Er?

[lukeskywalker]

My urine has been dark now for a few months and I'm pretty sure their is blood in it.

Anyway, I'm in Chiang Mai and want to see a doctor about it. I have BUPA insurance which only covers me as in in-patient (ie, overnight stay). Should I find a urologist or check in through the ER route and let them direct me where to go?

BTW, the doctors are always more than happy to put me in for the night so that insurance will cover it. I only need ask. They know it's more money for them and the hospital too.

Thanks!

[Morakot]

See your doctor right away; you may have haematuris.

http://www.nhs.uk/conditions/blood-in-urine/Pages/Introduction.aspx

[richardjm65]

A check of your urine will establish the presence (or not), of blood. If that proves to be the case, I'd next suggest an appointment with a urologist who will order further diagnostic procedures and recommend suitable treatment.

You say your urine colour has been dark for some time - is there a possibility that you are simply under-hydrated? Try increasing your water intake substantially and see what happens.

It could be something quite simple and inexpensive to treat. It could also be a symptom of something more sinister.

So, urine test ASAP, I'd suggest.

[jrtmedic]

Go here for an overview of the causes http://www.mayoclinic.com/health/urine-color/DS01026

Assuming that you are well hydrated then a urinalysis will help determine which "specialist " would be best placed to provide advise/further investigation/ treatment

[Sheryl]

Agree with above. get a urinalysis first to see if there is really blood as opposed to just very concentrated urine. If there is blood, consult a urologist.

Unless accompanied by high fever or severe pain, this is not something that belongs in an ER.

A urinalysis coats maybe a 100 - 200 baht.

[lukeskywalker]

Thanks for the suggestions. I know it's not dehydration, I've made sure to stay very hydrated.

If I do need a hospital in Chiang Mai, can anyone recommend which hospital would be best for this type of problem?

Where's best (cheapest) place just to get the urinalysis test? If there is blood, wont a hospital do another urinalysis anyway.

Edited February 22, 2013 by lukeskywalker

[Sheryl]

A urinalysis anywhere is going to be cheap. But if you feel certain it is blood, go ahead and consult a urologist, he sill certainly then order one. (or if you get the test first and it shows blood, bring the test result in with you).

I recommend you see Dr. BANNAKIJ LOJANAPIWAT. You can consult him either at Sri Pat ("SUan Doc" or "Special Medicval Services", a semi-private OPDA arrangement at CM University Hospital) or at the CM Ram Hospital. It will cost more at the Ram than at Sri Phat. He is at the Ram Wednesdays 5-6 PM and Sundays noon - 1 PM only. I don't know his hours at Sri Phat biut it's a fair guess he's be there Mon, Tues, Thurs evenings, maybe also Friday. He's a Professor at the Medical Faculty so private practice only in the evening. I hear he also has a private clinic of his own, don't know location.

If it turns out to be anything major then definitely stick with Sri Phart/CMU as it is by far the best equipped facility in northern Thailand.

Sriphat Medical Service Centre, Chiang Mai University 110/392 Sriphat Building, Inthawarorot Road,
Sriphum, Muang, Chiang Mai 50200


Tel 053-946900-1
 Mobile : 08-1681-1616
Website: http://www.cmed.cmu.ac.th

[Sheryl]

One other possibility that occurs to me is that it may be bilirubin that is in your urine rather than blood, it is easy to mistake the two. Urine with bili looks dark orange-ish.

If it is that points to a liver rather than urinary problem.

There is a simple test you can do yourself for bilirubin in the urine, which is to pee into a jar and then vigorously shapke it, if it is bilirubin there will be foam at the top.

Urinalysis may or may not check for bili. Try to ask specifically that they do. Or if you have the test and it shows no blood, ask the doctor if it could be bilirubin.

If it is bilirubin then different specialist needed.

Another way you could approach all this is to start with a basic physical check up that includes urinalysis and blood work inclusive of liver enzymes and bilirubin. The liver enzynes are prettuy standard but you may have to request the bili. Not expensive to add on, few hundred baht at most.

That will show if there is blood or bili in the urine and also if any liver inflammation or impairment. If liver enzymes and/or bilirubin come back elevated (and/or if bilirubin confirmed in the urine ) would need a hepatitis panel. Can be done on the same blood specimen already drawn if the lab still has it, which they usually do. (You could also just do a hepatitis panel to start with but as it is more expensive I suggest waiting to see if abnormal enzymes or bili.

[dominique355]

Just saw this topic and I hope it's not too late.

GO SEE A SPECIALIST IMMEDIATELY!!!

I had this symptom 13 years ago, blood in my urine while I was in a vacation in Thailand. Back home in Europe, I went to see my doctor who transferred me to a specialist in the urology department of the University Hospital. After a few more tests, they were pretty sure I had cancer in a kidney. So surgery was scheduled.

To make a long story short: I did have cancer on my right side kidney and it was removed, totally.

Since then I live with one kidney, no problems at all. But.... if I hadn't seen a doctor right away, probably I would not be alive anymore.

So please go see a specialist asap.