Hi Doctor; my girlfriend and I have been having sex

Patient

Q: Hi Doctor; my girlfriend and I have been having sex for the past 3 days, we live in different countries so we hardly meet each other. Yesterday she told me that she saw a trace of blood in her urine when she wiped, it appeared very diluted as it looks rather pink than blood red. This morning she told me that there is more blood when she urinates and she felt a burning sensation. We are both 19 and do not have STDs. Right now she is extremely scared and we do not know what to do. Some people said that it might be caused by rough sex but the bleeding did not start right after we had sex but about half a day after.

Symptoms:  Urine blood after intercourse, burning sensation
Doctor

A:   Hello,
Thanks for the query to ATD for an opinion,

The blood in urine and burning sensation is indicative of a urinary tract infection which can be acquired most frequently by women after sex due to shorter urethra. The infection need not be a std like chlamydia or gonorrhoea but can be simply an E.COLI or ureaplasma infection which shall present in a similar manner and shall require an antibiotic course for treatment.

Secondly similar symptom are also seen in cases of peri-urethral abrasions during rough sex which may burn once the warm urine touches it and also the healing lesions with clots may dilute with urine giving it a reddish tinge. The best would be to seek a per speculum examination by a gynecologist along with a urine culture test to isolate the causative organism and then can opt for treatment accordingly. In the meantime she should increase her water intake to allow speedy flushing out of infection due to frequent urination.

I hope i have answered your query in detail,
Wishing you good health,
Regards

Comments / Follow Ups

Patient: She just told me that the most recent few times when she passes urine, the urine does not appear to be mixed with blood and the burning sensation is very little. At the end when she passes urine, there is blood dripping down with strong burning sensation. Besides that she has no fever of abdomen pain, just drips of blood from urethra after urinating. Is this still the same symptom? Just want to know that is it very necessary to visit a gynaecologist or we should observe the symptoms and wait for about one or two days and see whether the bleeding gets worse. Thank you
Doctor: If she is sure that the blood is coming out of urethra and not the vagina then its a clear cut urinary tract infection with cystitis that she has developed else this could just be collected blood in the posterior fornix in the vagina secondary to vaginal abrasions following rough sex which comes out on straining and seen dribbling out as darkish brown colour often post urination. You may wait for 36 hrs to watch for further symptoms but increase water intake in the meantime.
Patient: Thank you very much Doctor, just want to add on if she has a urinary tract infection with cystitis then what should we do? Is it very serious ? Except increasing water intake do you recommend any other medications?
Doctor: If its a urinary tract infection then a course of antibiotics would be must.
Patient: Alright thank you very much doctor, we appreciate your help.
Doctor: you are most welcome. Take care.
:)

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