Discussions By Condition: I cannot get a diagnosis.

How come I can,t

Posted In: I cannot get a diagnosis. 2 Replies
  • Posted By: bigboy
  • October 31, 2010
  • 00:59 AM

Over the last couple of months I have been posting questions pertaining to skin and urinary problems but I have never gotten any responses.I would like to know how come I can never get get any respones here.:cool:

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  • Over the last couple of months I have been posting questions pertaining to skin and urinary problems but I have never gotten any responses.I would like to know how come I can never get get any respones here.:cool:Here is the better question my friend.Why are you more concerned about the itch more than the intermittent gross hematuria?The pathophysiology of hematuria depends on the anatomic site in the urinary tract from which blood loss occurs. A distinction has conventionally been drawn between glomerular and extraglomerular bleeding, separating nephrologic (kidney) and urologic disease.Blood originating from the nephron is termed glomerular or nephronal hematuria. 5 RBCs can enter the urinary space from the glomerulus or, rarely, from the renal tubule. Disruption of the filtration barrier in the glomerulus may result from inherited or acquired abnormalities in the structure and integrity of the glomerular capillary wall. These RBCs can be trapped in Tamm-Horsfall mucoprotein and will be manifest in the urine by RBC casts. Finding casts in the urine represents significant disease at the glomerular level. However, in disease of the nephron, casts can be absent and isolated RBCs may be the only finding. The presence of proteinuria helps support a glomerular source of blood loss.Hematuria without proteinuria or casts is termed isolated hematuria. Although a few glomerular diseases may produce isolated hematuria, this finding is more consistent with extraglomerular bleeding. Anything that disrupts the uroepithelium, such as irritation, inflammation, or invasion, can result in normal-appearing RBCs in the urine. Such insults may include malignancy, renal stones, trauma, infection, and medications. Also, nonglomerular renal causes of blood loss, such as tumors of the kidney, renal cysts, infarction, and arteriovenous malformations, can cause blood loss into the urinary space.That seems a tad bit more important at the moment. According to your urinalysis and physician, which category does your hematuria fall under?Constitutional symptoms such as fever, arthritis, and rash may suggest a glomerulonephritis associated with a connective tissue disease such as systemic lupus erythematosus. Hematuria or cola-colored urine following an upper respiratory illness is seen in immunoglobulin A (IgA) nephritis. Henoch-Schönlein purpura (HSP), the systemic variant of IgA nephritis, is commonly associated with palpable purpura of the skin and gastrointestinal manifestations. Absence of constitutional symptoms does not rule out a glomerulonephritis, however, because many primary renal diseases may manifest with only hematuria or proteinuria (or both).A careful history of pain symptoms should be conducted. Suprapubic tenderness accompanied by dysuria, urgency, or hesitancy is found in cystitis. Prostatitis and urethritis also result in symptoms with urination. Severe pain in the flank, with radiation into the groin, is seen in ureteral distention or irritation by stones, clots, or other debris, such as that found in papillary necrosis. The rare loin pain–hematuria syndrome can have a similar pain pattern. Renal capsular distention from inflammation (pyelonephritis) or hematoma (trauma) can result in costovertebral angle tenderness. Bleeding or infection in a renal cyst can also result in costovertebral angle tenderness.The characteristics of the hematuria can often help distinguish the cause and location of bleeding. A glomerular source of bleeding usually results in persistent microscopic hematuria, with or without periods of gross hematuria. In renal sources of hematuria, the blood is equally dispersed throughout the urine stream and does not clot. If clots are present, it is important to ascertain where in the urine stream they occur. Hematuria or clots at the beginning of the urine stream, initial hematuria, is a symptom of a urethral cause. Terminal hematuria, occurring at the end of the urine stream, may occur with a prostatic, bladder, or trigonal cause of hematuria.Important physical examination findings in the patient with hematuria may include fever and hypertension. The examination should include a search for signs of the above-mentioned systemic illnesses, such as rash and joint tenderness. Complete abdominal and back examinations should be performed to evaluate for tenderness or masses. In men, a complete genitourinary examination, including the prostate, is important to look for any visible urethral lesion or evidence of prostatitis.
    keanhe 86 Replies
    • October 31, 2010
    • 02:28 PM
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  • I just found out why I have this hematuria.I have a ureter stone.It seems to be stuck in place.I was told that the xrays show no sign of hydronephrosis because while it is stuck the shape of it is allowing urine to flow by.I have no flank pains because it is not causing my ureter to spasm.I have read that it is ureteral spasms is what causes the pain in most people with stones.I will be getting it removed this week.The reason I ask the question why can,t I get a response was because I had some concerns that I may have offended some people without intention when I replied to some of their posts.Thank you for your reply and your concerns for me.:cool:
    bigboy 64 Replies
    • October 31, 2010
    • 09:22 PM
    • 0
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