### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hello. I have systemic lupus (calm). I usually get lab work done 1-2 times a yr. to check my kidney, etc. due to the lupus.  Three yrs. ago, June 2010 Ive been having occult blood (1) in my urine. I asked my Rheumatalogist and she said I probably took the urine test close to my period or near the end of my period and thats why it showed the occult blood, so I didnt worry anymore. This July I had my lab work done and again the occult blood (1) showed up (as it has been in the last 3 yrs.). This time however my Rheumatologist was concerned and told me to see a urologist. Because I couldnt see a urologist sooner, I went to see my family doctor. He ordered a urine test and an ultra sound of the kidney. He diagnosed me as microhematuria. When I finally saw the urologist, she ordered a urine cytology and recd that I get a cystoscopy esp. because my lab showed  occult blood (1) along with rbc 4-10 . She wanted to make sure that I dont have a bladder cancer or kidney disease so a cystoscopy needed to be done. When I did the urine test that day, I believe the cup was contaminated thats why it showed the rbc 4-10. When repeated, it didnt show rbc 4-10, but normal  rbc 0-2 (below)Results:   1. Urine---   no infection, occult blood (1), rbc 0-2   2. Ultra Sound of Kidney---   3 x 5 mm nonobstructing stone in the inferior pole of right kidney3. Urine cytology---   benignI recently talked to a 2nd urologist at a social gathering and he told me that I should get an x-ray, kub to see accurately the size of the kidney stones, etc.  He actually recd a ct scan but changed his mind when I told him that I was trying to get pregnant. So with that info., he recd me to get an x-ray instead. He also recs that I get rid the stones asap even though I have no pain because if I get pregnant it would be bad.  QUESTIONS:1.  Should I get the x-ray done when the ultra sound already shows the amt. and size of the stones? I would think the ultra sound and x-ray both show the same size and amt. of stones even though they are two different tests.2.  Should I still get the cystoscopy even though I have benign in urine cytology and  that I have occult blood due to kidney stone (from ultra sound) ?3. Should I get rid of the stones since Im trying to get pregnant even though I have no pain?4. The 2nd urologist recd I get lithotripsy done soon before I get pregnant even though Im not in pain. Is this the correct or recd procedure?Thanks.

### output:

Hi there, she can affect kidney the best way to detect is RBC in urine examination> 4, urine spot protein creatinine ratio > 0.2 and high DSNA and low c3 levels. Then we call it lupus nephritis.  In your case stone is also present. So RBC can be because of stone also. It is important to rule out SHE nephritis as it is more dangerous. X-ray may not be helpful.  If you wantvimaging study to document stone size and number than ct pub plain should be done. It has no effect on future pregnancy.  If the stone is a single stone of 3 to 5 mm as in the ultrasound.  There is no need of anyvtreatment before pregnancy.  If a problem arises it can be tackled as such chances are very less as it is a very small stone. Chancellor cancer are only there if your age is greater than 50 yrs in that case also ct should be done before cystoscopy. And most likely cystoscopy will not be needed. Best wishes.