Dr. Clinton Wood Collins, MD

Typically a urinalysis would not say “pus.” White blood cells or leukocytes are what is usually reported in a urinalysis, and while this can be due to a bacterial infection, it could also be simply from inflammation from anywhere in your urinary tract (kidney, ureter, bladder, urethra, prostate in men).

Usually, blood in semen is not an indicator of malignancy or infection but it would be best to be seen by a urologist for hematospermia.

A urinary tract infection is just that - of the urinary tract. Your vagina should not harbor urine or it’s infection. It is theoretically possible for you to transmit UTI to male partner, but due to the male anatomy (longer urethra), men are generally less prone to UTI than a woman, and the source would generally be felt to be less likely due to bacteria at a male urethral meatus. If you are having recurrent infections, it would be reasonable to use a condom to see if this decreased your own recurrence, although UTI with intercourse is less likely due to male factor, and more likely due to contamination from vagina and/or fecal bacteria that may be present in vagina.

There are various reasons the flow of your urine could be intermittent and of decreased intensity. You should see a urologist to evaluate for the possibility or urethral stricture (scarring of the urethra that results in narrowing-often associated with history of gonorrhea or straddle/perineal trauma), dysfunctional voiding (inappropriate contraction of bladder neck and urethral sphincter when bladder is contracting), poor contraction of the bladder (from possible underlying undiagnosed neurologic abnormalities), in addition to other possible causes. Your flow can be measured to see if it is even actually abnormal. Urinary symptoms can be caused by various, even contradicting causes (the bladder may be overactive or underactive, and a patient may have the same symptoms). It is best to be evaluated by a board certified urologist.

Any gross hematuria (seen to the naked eye) should be evaluated by a urologist. In absence of active infection, if you see blood in your urine, you should have imaging of your kidneys, preferably with IV contrast to outline the kidneys and drainage of your kidneys. You should also have cystoscopy performed, which is a short procedure, much like having a urinary catheter placed, during which a urologist can fill your bladder with saline and visualize the inside. This will rule out tumors, foreign bodies, tumors, or other anatomical abnormalities.