Patient: Hi , should I worry about about small white debris in urine? Very sporadic, sometimes 1-0 a month to 3 times in a week or nothing in 2 months.Just after I finish peeing the last ml are cloudy white and contain this debris. If I don’t let it out completely it causes a very weak burning like something is still in the urethra which bothers a little but goes away if I don’t pay attention after about 15 mins. I found out that if I let some of these drops dry in the toilet seat they turn into a white powder or chalk mark .Had urinalysis in December everything normal including 0 WBC but 1-2 erythrocytes per field( normal 0-1) , scarce epithelial cells and scarce bacteria. Also scarce sediment ( but classified as normal in test parameters)Also blood chem test everything good except 44mg/dl triglycerides and LDL/HDL ratio 2.4(3.0-4.0 normal)I hope this is nothing but wanted an opinion to know if should do any visits to the doctor or follow ups. Thank you
Symptoms: Debris in urine
Doctor: Hi.Read and understood the occurrence of sediments as you have very nicely explained.You are young and unless you h ave a habit of not drinking sufficient amount of liquids and water , such sediments without much symptoms should be taken very seriously.I mean should be investigated well.I would advise you the following in such a situation:- First of all to go for good ultrasonography of the abdomen particularly for the genitourinary system.You should prepare yourself by taking two tablets of Dulcolax/ Gerbisa and 6 tablets of Gasex the night before and fluids only orally the day before and nil orally after 10 pm of the previous night. This clears all the feces and gases out of the intestines, then only the ureters may be seen.- This should be followed by CT scan and Intravenous pyelography (CT scan may also give good quality contrast study of the genito-urinary system)These tests are very important for the following reasons:-To see for the presence of stones and sludge in the urinary system.-To see signs of specific diseases like tuberculosis (the powdery substance in urine without any symptoms may be due to such diseases) and others.- Cysto-urethroscopy and (ureteroscopy if possible)- Repeat Urine analysis for 3 consecutive days and also get culture and sensitivity done.- Blood Urea, creatinine, uric acid, calcium-Ultrasonography of the neck for parathyroid glands.All these measures are done to rule out or confirm the possible causes of your problem.Please consult a General Surgeon or better an Urologist for clinical evaluations and investigations and possible treatments.-Once all the tests are done start the following:Plenty of water orally.Antibiotics if there is evidence of infection.any other treatment as per the causes found.I hope this answer helps you to get an appropriate diagnosis and treatment.Lipid profile may not be connected to the present problems and you may please please discuss about this with your Physician.Please feel free to ask further relevant queries if necessary of if you feel that there is a gap-of-communication.
Comments / Follow Ups
Patient: Thank you altough if i just noticed the sediment about 2 months ago (thanks to the blue seat), maybe i had it before or less frequently but now im constantly thinkig about it,
but the sporadic(once every 2-3 months) weak burning has been around for about
2 maybe 3 years wouldnt that rule out some conditions that would have caused more symptoms already?
I ask this because now that you mentioned it i do live in a very hot city average 30 degrees celcius but mainly 32-38 year round. just how much water should i be
drinking? my pee is usually light yellow sometimes more/less but average i would say i drink about 1-1.5 lt of liquid (milk every morning, soda, water).
also i dont know if its related but it has only happend 3 times in about 3-4 years, I woke up in the middle of the night with urge to pee but
i noticed a stain in my bed with a transparent pee like liquid (maybe diluted seminal fuild?) with no smell, i peed afterwards and everything else fine.
i believe this may be related to drinking a lot of water and not peeing everynight before bed as usual those nights and to gas and diarrhea pressing in to my
bladder( celiac episode as far as i remeber at least 1 of those nights).
and also i dont know if it helps but ive see my gastro regularly and he has performed physical exams in my stomach and he hasnt noticed anything weird or pain
(like associated with kidney stones or inflamed organ)
i wasnt able to upload it here but here is a picture of the sediment in urine: http://postimg.org/image/3orb22jx5
Again sorry keep asking but im pretty hypochondriac, thank you!
Doctor: Hi.Thanks for your feedback.
As I said, you can ask me any number of question which are relevant.
Many conditions are symptomless and there is where the patients and/Doctor get stuck and the diagnosis is made late.
This is the need to get all the investigations as I mentioned.
Water: How much?
Urine anytime should be colorless throughout 24 hours, the moment you have even a slightest yellow tinge or darkening of the urine, this is the simple indication that you have taken less than required water.
About the incidence in the nights where there was an urge to pass urine but has stain can be due to precum or prostatic fluid from congestion. May be you are right, but the quantity you are taking is not much, just up to 1.5 liters per day.
Gastro may not be in a position to detect anything related to Urinary problems.
Please do not be sorry for asking, this is a good platform where you can have great interactions.
I hope this answers all the queries you have asked.