Urology

There are half a dozen things that can cause pain in the urethra. Kidney stones are one of these things, however you did not have stones show up on ultrasound. That said, kidney stones in the early stage can be so fine as to be smaller than a grain of sand, and look like just a little grey sludge in your urine. It's bizarre to think they were looking for cancer, so throw that idea out.

There are other things completely unrelated to kidney stones that can cause urethral pain, such as a small skin tear or skin flap inside the urethra. These things happen for innocuous reasons like masturbating too hard, exerting yourself during exercise or sports, riding a bicycle, or no reason at all.

Microscopic amounts of blood aren't necessarily sinister, and may disappear as mysteriously as they appear, and also be related to a small tear or skin tag that gets torn when you urinate. What you don't want to see is visible blood or dried blood, but even then it may just be injury or temporary.

No one wants a catheter insertion. Intermittent and minor pain that lasts more than a couple weeks should be investigated, and yes, probably with that procedure.

For a wealth of information about kidney stones, check out the web site http://www.urologystone.com where there are more than 3000 pages of information. Your questions about stones require answers far too lengthy to post here.

Beyond that, there are also such things as prostate stones, parasites, anxiety, nerve impingement, and other causes of urethral pain. Without your urologist's help, it may be exceptionally difficult to track down the cause, but expectedly none of the investigation what would be described as pleasant.

The STD swab you experienced previously is a dry cotton swab on a hard wooden stick, so of course it's not pleasant. Not saying that a cytoscopy is pleasant, it's not, but it's quite different. Hopefully you will be able to avoid it, but don't let your pain go unattended in the long hope it will just one day go away.

Thanks. You soind very knowledgeable. Are you a doctor by any chance?

I guess what I would like to know is what the scan checks for? The ultasound already checked he kidney and bladder so this sounds like perhaps it would find smaller stones the ultrasound missed. I'm not sure the cystoscopy would find a a small skin tear or skin flap inside the urethra since it is looking at the bladder. Would the cystoscopy find the other things you mentioned like prostate stones, parasites, or nerve impingement? If not aren't there less invasive tests that could be done to narrow things down? I just don't want to have another procedure that turns out it didn't find anything.
Isn't there a blood or unrine test that can check for the possible presence of stones. Finally, would the cystoscopy tell what kind of stone it was? Because if they did find some what would the next step be?

The ultrasound can only see stones that are large enough to be seen. It will not show the sandy grain sized precursors to larger stones. Sometimes these can be caught with a strainer cup, but again may be so small as to appear as sludge to the eye, even though they're very small crystals. This isn't exactly a test as much as a confirmation.

The cytoscopy is going to be looking at the whole path on the way to the bladder, not just the bladder, or at least it should be. It would not find any of the other three things you listed. Parasites are a different test (usually something your internist would evaluate, and may be nothing more than a questionnaire, all the way up to blood/stool test), nerves are checked by a neurologist, and I don't actually know how they find prostate stones other than symptomatically, except perhaps by ultrasound in that area.

Your urologist can do a 24-urine as it's called, to check the chemistry of your urine. If they find unusual chemistry, this can indicate that stone formation is more likely. It's not a diagnostic as to whether you have stones forming, only measures a situation where stone formation is more likely.

This exchange is not actively monitored by a physician. While I am a licensed healthcare professional, I am not a medical doctor and cannot offer medical advice. I am also the WebMD Ambassador for this Exchange.

Thanks. I thought those tests wouldn't detect those other possible causes.

Do the stones form in the bladder or the kidney? I should review some diagrams but I thought the most severe pain was when the stones traveled from the kidney to the bladder and once they were in the bladder the worst was usually over.

THe good news is I really haven't had the sharp pain in a week and it was very sporadic when I did have it. I think I did pass some kind of stone once as it appeared some black thing seemed to be sinking in the toilet bowl during urination over a week ago.
Even if the cytosocpy found stones or stones forming they wouldn't know what type they were and therefore not know how to treat them. If so how would I be any better off if they couldn't do any treatment at that point?

I really need to refer you to http://www.urologystone.com because a lengthy discussion of kidney stone formation is more than this Exchange can handle.

Stones form in the urine. Urine comes from the kidneys and is conducted to the bladder. Stones may get lodged and cause pain in either the kidneys, ureters, or urethra.

The vast majority of stones are calcium oxalate stones, not uric acid stones. The urologist will often as you to use a strainer cup every time you urinate to collect very small fragments for analysis, but the general assumption is that they will be oxalate stones. The issue with stones in the bladder is that they can block the exit for urine to be excreted, causing urine retention and possibly serious infection. All stones must be passed or made smaller so they can pass or else they will cause problems, today, tomorrow, or next week.

A cytoscopy isn't to find stones in your bladder.