Question

“I am a postmenopausal female. I have had bleeding for over a year. I thought it was vaginal, as I only see it upon urinating. I would also get a little pink on the tissue paper. Had a recent urine test done and needed to go on antibiotics. Took meds for 5 days and now the bleeding is back. The blood stopped while I was on meds. Could this be another bladder infection?”

Answer

Vaginal bleeding can be most likely due to menses and in postmenopausal woman; it can be due to fibroids in the uterus or other conditions.  When there is suspicion that this could be coming from the bladder, a urine test should be performed and if the urine test indeed shows the presence of blood, then the patient requires some formal workup for the symptom of blood in urine, which is called hematuria. A complete hematuria workup will require a cystoscopy, which means using a cystoscope or fiber optic instrument to inspect the bladder, obtain an imaging test to visualize the kidneys and the uterus, which are the tubes that connect the kidneys to the bladder, and also studies of the cells of the bladder, to rule out the carcinoma in situ.  In addition to this, those urine samples should be cultured to identify whether there is presence of bacteria and if they grow, an antibiotic treatment would then be more appropriate.

by Dr Fernando J Bianco
Miami urology