My last 3 runs have yielded some awfully dark/red urine…anyone have any experience dealing with this? I do have a history of kidney stones, but show no symptoms now. help!
1st off I have an exercise phys degree. That being said I’ve worked in healthcare for 10 yrs including hospitals. If I remember correctly if the blood is intermixed w/ the urine it is probably coming from the kidneys. If it occurs at the end of urination if probably comes from the bladder, if in the beginning from the urethra. You would be smart to go see your physician. It could be a stone, a lesion in the urinary tract or something else. I’d personally go see my PCP, first thing in the morning BTW.
Better safe than dead was our motto in cardiac rehab.
This is a no brainer… you should see a doctor immediately especially since you have a history of renal stones. What you are describing is gross hematuria… this is not normal… it could be anything from discoloration from vitamins to actue renal failure. There is no way of telling from your two line description. You say no symptoms but hematuria is inandofitself a symptom/sign of a possible pathological event…
The only way to tease soemthign like this out is with a sampling of urine and perhaps some blood tests to asses renal function.
Taku, gross hematuria is a sign, not a symptom.
I would recommend a CT scan, with and without contrast. Also consider a cystoscopy, particularly if over 40 years of age and certainly if the CT is normal. Further blood and urine tests are not the only nor the advisable way of teasing something like this out. At least that’s what I read in “Dear Abby”.
Yo are right of course about the hematria being a sign… couldn’t you also argue that seeing gross blood in the urine as being a symptom if the patient reports it… (not that important… just a thought)
Would you really skip to CT before doing a renal US, UA or Lytes to asses renal function, and overall r/o a renal cause of the blood. (ie. Berger’s, analgesic nephropathy etc. )
Obviously a cystoscopy and a full GU (cystis, urethritis, prostatitis, papillary necrosis, etc. etc.) would be indicated if renal causes were ruled out… I guess the idea of having someone put a camera up my penis makes me cringe.
I guess the main point that I was trying to make is that blood in teh urine is not normal and that he should go to the doctor to have it evaluated
Not that I’m telling you that you shouldn’t get it checked out, or that there couldn’t be a more serious cause, but there are common benign explanations specific to running, including running associated bladder trauma, red cell leakage (running can cause transient glomerular membrane leakage of red cells), and foot strike hemolysis. If you have Noake’s new edition of “the Lore of Running” or can get it at the library, there are a few pages on the topic. BTW, this book is one of the most amazing running / sports physiology / sports medicine books ever written, and is a great source of evidence based knowledge in our testimonial-filled sport. Big section on Mark Allen too.
Deke
thanks for the input. Masters swim coach is an internal medicince doctor and told me this morning that its probably an empty bladder banging against itself breaking cappalaries…i cant see doing the penis cam…scares me to death…gonna see if i can get kidney scan from a urologist…thanks again for the input
Of course you’d check lytes, but that’s not going to tell you where the blood is from. A UA will tell you what you already know- there’s blood in the urine. You always do it but it rarely tells you anything you don’t already know. I can tell you, most nephrologists want ‘anatomic’ causes ruled out first before medical renal disease, and not vice versa.
As far as ultrasound, it’s not sensitive or specific enough to r/o much of anything. A negative US, you’ll likely proceed to a CT as a more sensitive modality. A positive US, you’re going to need a CT for further detail. So skip the US. it delays the needed tests and adds to the total cost.
You’re right. gross hematuria should always be evaluated. And before any tests, the oft neglected history and physical exam needs to be done.