I have blood in my urine and debris in my bladder, constant fatigue coupled with bouts of nausea, lower back and rib pain. no uti present.

See below: A urinary tract infection would be the most common cause to explain this combination of symptoms and urine culture is most accurate means of UTI diagnosis. The presence of blood in the urine (hematuria) especially if visible is also cause for concern. Stones and/or tumor need to ruled out. Recommend urological evaluation which may include blood tests, U/A, urine culture, CT urogram, cystoscopy.