Exercise induced Hematuria - common or not ?

sloboy

So I had a pretty spectacular blood in urine episode after my ride last evening (it was like p1ssing red wine I tell ye - had me going "What the fnck is that !!")

The geezer on NHS Direct reckoned it was pretty common, and if it:

- came on with exercise
- was a one-off
- no pain associated anywhere
- cleared up by itself in 24 hours (actually took about 4hrs)

then probably not to worry. Obviously his Googling skills are better than mine, cos he although he came up with "common", I came up with "rare for cyclists".

I've certainly not experienced it like this before - maybe after getting home after a long ride on a hot day, I've thought that my pee was a bit off the normal colour chart, but not the colour of Chianti !

So what's the view of the panel ? Common or not ?

Ben6899

Another fella on these boards (mcflyss) has been seeing his GP and a couple of Urologists for something similar/the same.

sloboy

Ah yes - thanks for the link.

My googling said pretty common in runners, swimmers and rowers. Less reference to cyclists. More likely when dehydrated. More likely in men than women. Blood in urine not likely to be prostate related (although blood spots on underwear IS likely to be prostate related). More likely with age.

Being 50 myself now, I had hoped to delay the onset of a regular DRE, but i guess there comes a time in every man's life ...

antooony

Been there done it. Quite scary. Got checked out just in case and all was normal.

sloboy

Update. Don't listen to the bloke on NHS Direct is my advice.

Next ride, same thing again (more or less - not quite as dramatic, but pretty close), so off to the doc I go.

I reckon he'd decided on a referral to a urologist in the first 2 seconds and would have done the same if I'd trotted in there last week. Which would have been more sensible, obviously.

term1te

I had a works medical recently, and it came back with too much blood in the urine. Not visible but detectable somehow. I had to go back a week later when it was at an acceptable level. The doctor told me it was fairly common for cyclists if you use a particularly aero position on the bike. Apparently it squashes the kidneys which can cause slight damage, and some blood. I had done some TT training a couple of days earlier so guessed that was it. He said it was also common among squaddies who march about with heavy backpacks, again squashing the kidneys.

Radioactiveman

Unless you have being playing rugby,had a bad crash etc I would visit your GP and not risk it.

I have kidney stones and this often cause blood in piss.

If your piss is red and you havent been drinking beetroot juice something is wrong. Large amounts of blood in the urine is also a symptom of bladder cancer.

TommyEss

Term1te wrote:

Not visible but detectable somehow.

Microscopy I believe. There's micro and macroscopic haematuria, followed by gross haematuria. Essentially, your pee either looks normal but has a small number of blood cells in it, it's tinged a bit pink, or it looks like something out of a horror movie.

Radioactiveman

TommyEss wrote:

Term1te wrote:

Not visible but detectable somehow.

Microscopy I believe. There's micro and macroscopic haematuria, followed by gross haematuria. Essentially, your pee either looks normal but has a small number of blood cells in it, it's tinged a bit pink, or it looks like something out of a horror movie.

Yes you are correct had all 2 at some point. As you say gross is quite a shock. Anywhere between vimto and rose wine for me. Not happened for a long time thankfully

sloboy

Radioactiveman wrote:

Unless you have being playing rugby,had a bad crash etc I would visit your GP and not risk it.

Large amounts of blood in the urine is also a symptom of bladder cancer.

Quite right on both accounts. Gross in my case, and that's a pretty good description ! I'd rung NHS Direct really expecting them to tell me whether to get down to A&E or just make an appointment to see my GP. I was surprised when they said "Neither"

As you say, it can be a sign of something serious, but it isn't necessarily so. Still, that's what the camera up the willy was designed to establish. :shock:

sloboy

Ok - think I can tie off this thread in case of later searching.

I've just completed the usual workup for a "visible blood in urine" - so it's comprised blood pressure, physical exam of me bits, blood test, 3 urine tests, digital rectal exam, CT urogram and today a cystoscopy.

All fine, so the only remaining steps are a 6-week follow up cytology (another urine test) and a 6-month follow up X-ray to check on the progress of the kidney stone that the CT scan showed up.

Reading as I've gone along around the subject, I'd say:

- visible blood in urine is a potential sign of something serious. Something around 30% of people who present with that symptom and no others will be diagnosed with cancer. If you have other symptoms as well, that makes other conditions (infections etc) more likely.

- the odds of being diagnosed with cancer are probablylower than that when it's come about with exercise and you have no other risk factors (smoker, heavy drinker, exposure to certain industrial chemicals). My consultant said he thought there was a 10% chance of finding something on the CT scan. Not sure if that was just to indicate to me it was ok to be worried or if that was his realistic estimate.

- if you get it, get down the doc's. I can't say that either the CT Scan or the cystoscopy is something I'll be taking up as a hobby but they're not so bad. You'll be taken seriously and likely you'll be put on the 2 week referral target as they take the view that they're working to eliminate the diagnosis of cancer. Therefore the process will all chip along quite nicely.

In the meantime, I've been out on my bikes a couple of time without any visible side effects, but since the occurrences were both associated with cycling, it seems only right to assume that something in the riding position or cycling action must have helped induce them. My saddle was pretty knacked anyway and it seems like the obvious thing to change, so you'll see me stalking e-bay to try new shapes to see what should replace my Arione.

Cleat Eastwood

Awww was just having a hot dog with tomato sauce for me dinner.

Stewie Griffin

If I ever get blood in my urine the next thing I will have is poo in my boxers :shock:

seemunkee

Had trace amounts of blood in my urine and had a kidney removed a few weeks later for cancer.
Good thing to have done all the follow up.

deptfordmarmoset

I got something which I think was called ''hematospermia'' from a long ride with a bad saddle on a bumpy track. Or maybe from eating beetroot... No, I think it was the saddle. I stayed off the bike for a while and it hasn't reoccurred.

Radioactiveman

Was it like rice pudding with jam in?

deptfordmarmoset

Radioactiveman wrote:

Was it like rice pudding with jam in?

Strawberries and cream...

Cleat Eastwood

This thread is taking the bloody piss.