Is it possible to pass out parasites in my urine?

Doctor's Answer

Hi,

I am sure anyone would be worried after your experience.

First of all, it is possible it was already in the toilet bowl, especially if:

1. you could see it with your naked eye and

2. you have no urinary symptoms

However, it is also possible that the organism could have been "dragged" by the urine from the skin, vagina or anus during the urination process in women.

This is because the urine stream can "washout" the genitals before going into the toilet bowl.

For example, parasites like Trichomonas vaginalis or Enterobius vermicularis, as well as their larvae can contaminate urine in this way.

There other parasites that can infect the urinary bladder, like Schistosoma haematobium, which indeed could be passed directly during urination.

Even larger parasites like Ascaris lumbricoides have been reported to infect the bladder after an abnormal passage way between the intestine and the bladder was formed. This can cause urinary tract obstruction (see picture of an Ascaris worm inside a urine bag taken from the internet).

Ascaris in a urine bag

In addition, Strongyloides stercoralis is a parasite that can infect immunosuppressed patients like transplant patients. This parasite can also be detected in the urine.

These are just the most common examples.

Most likely everything will be ok, so try not to worry and do not jump to any conclusions.

You can consult a general practitioner, nephrologist or urologist to perform some investigations in your urine, like

(1) examination of the urine sediment (cells and debris in the urine) by a lab technician;

(2) urine cytology, which is the examination of the urine sediment under a more powerful microscope and with the help of special dyes by an expert pathologist;

(3) a urine culture; and

(4) whatever other tests your physician deems necessary after asking you questions and examine you.

If indeed a parasite infection is discovered, you might also need to undergo more special investigations and consult an infectious diseases physician.

Many other infestations and unusual infections can be detected in the urine.

For example, although they are not proper parasites, tropical parasite catfishes (very small fishes) can be caught by swimming in fresh water in certain parts of the world like the Amazon, and can actually enter the body through the urinary system.

Dr Francisco

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