Blood in Urine (Hematuria) Blood in Urine (Hematuria)

Blood In Urine (Hematuria)

Do you notice blood in urine?

Visit Steinberg Urology for a consultation with our urologists to address your concerns, perform diagnosis and provide you on advice as to what treatments are likely to fit your individual circumstances.

BLOOD IN URINE (HEMATURIA)

Hematuria is the clinical name for having blood in your urine. Seeing blood in your urine can be alarming. While in many instances the cause is harmless, blood in urine (hematuria) can indicate a serious disorder.

Hematuria can be either gross (visible) or microscopic (blood cells only visible through a microscope). Gross hematuria can vary widely in appearance, from light pink to deep red with clots. Although the amount of blood in the urine may be different, the types of conditions that can cause the problem are the same, and require the same kind of workup or evaluation.

People with gross hematuria will visit their doctor with this as a primary complaint. People who have microscopic hematuria, on the other hand, will be unaware of a problem and their condition will most commonly be detected as part of a periodic checkup by a primary-care physician.

Blood in the urine can be an early sign of urinary abnormality or problems in the urinary tract including kidney stones, urinary track cancers or large prostate. It’s important to determine the reason for the bleeding.

Although blood in the urine is not always a significant symptom of disease, it can be an important warning sign to a possible health problem. Bloody urine should never be ignored. The treatment of hematuria depends strongly on the actual cause of blood in the urine. The information collected from the medical history, physical exam, and any test results will be used to determine the best treatment option.

Make an appointment to see your doctor anytime you notice blood in your urine.

SYMPTOMS OF HEMATURIA

People with gross hematuria have urine that is pink, red, or brown. Even a small amount of blood in the urine can cause urine to change color. In most cases, people with gross hematuria do not have other signs and symptoms. People with gross hematuria that includes blood clots in the urine may have bladder pain or pain in the back.

Bloody urine looks different, but you might not be able to tell the difference. It’s best to see your doctor anytime you see red-colored urine.

Some medications, such as the laxative Ex-lax, and certain foods, including beets, rhubarb and berries, can cause your urine to turn red. A change in urine color caused by drugs, food or exercise might go away within a few days.

Contact your doctor right away if there is blood in your urine, especially if you are also suffering from:

  • Frequent, painful or urgent urination
  • Nausea, vomiting, fever, or pain in your abdomen

CAUSES OF HEMATURIA

In hematuria, your kidneys — or other parts of your urinary tract — allow blood cells to leak into urine. Various problems can cause this leakage, including:

Urinary tract infections

These occur when bacteria enter your body through the urethra and multiply in your bladder. Symptoms can include a persistent urge to urinate, pain and burning with urination, and extremely strong-smelling urine.

Kidney infections (pyelonephritis)

These can occur when bacteria enter your kidneys from your bloodstream or move from your ureters to your kidney(s). Signs and symptoms are often similar to bladder infections, though kidney infections are more likely to cause a fever and flank pain.

A bladder or kidney stone

The minerals in concentrated urine sometimes form crystals on the walls of your kidneys or bladder. Over time, the crystals can become small, hard stones. The stones are generally painless, so you probably won’t know you have them unless they cause a blockage or are being passed. Then there’s usually no mistaking the symptoms — kidney stones, especially, can cause excruciating pain. Bladder or kidney stones can also cause both gross and microscopic bleeding.

Enlarged prostate

The prostate gland — which is just below the bladder and surrounding the top part of the urethra — often enlarges as men approach middle age. It then compresses the urethra, partially blocking urine flow. Signs and symptoms of an enlarged prostate (benign prostatic hyperplasia, or BPH) include difficulty urinating, an urgent or persistent need to urinate, and either visible or microscopic blood in the urine. Infection of the prostate (prostatitis) can cause the same signs and symptoms.

Kidney disease

Microscopic urinary bleeding is a common symptom of glomerulonephritis, an inflammation of the kidneys’ filtering system. Glomerulonephritis may be part of a systemic disease, such as diabetes, or it can occur on its own. Viral or strep infections, blood vessel diseases (vasculitis), and immune problems such as IgA nephropathy, which affects the small capillaries that filter blood in the kidneys (glomeruli), can trigger glomerulonephritis.

Cancer

Visible urinary bleeding may be a sign of advanced kidney, bladder or prostate cancer. Unfortunately, you might not have signs or symptoms in the early stages, when these cancers are more treatable.

Inherited disorders

Sickle cell anemia — a hereditary defect of hemoglobin in red blood cells — causes blood in urine, both visible and microscopic hematuria. So can Alport syndrome, which affects the filtering membranes in the glomeruli of the kidneys.

Kidney injury

A blow or other injury to your kidneys from an accident or contact sports can cause visible blood in your urine.

Medications

The anti-cancer drug cyclophosphamide and penicillin can cause urinary bleeding. Visible urinary blood sometimes occurs if you take an anticoagulant, such as aspirin and the blood thinner heparin, and you also have a condition that causes your bladder to bleed.

Strenuous exercise

It’s rare for strenuous exercise to lead to gross hematuria, and the cause is unknown. It may be linked to trauma to the bladder, dehydration or the breakdown of red blood cells that occurs with sustained aerobic exercise. Runners are most often affected, although anyone can develop visible urinary bleeding after an intense workout. If you see blood in your urine after exercise, don’t assume it’s from exercising. See your doctor.

HEMATURIA RISK FACTORS

Almost anyone — including children and teens — can have red blood cells in the urine. Factors that make this more likely include:

Age

Many men older than 50 have occasional hematuria due to an enlarged prostate gland.

A recent infection

Kidney inflammation after a viral or bacterial infection (post-infectious glomerulonephritis) is one of the leading causes of visible urinary blood in children.

Family history

You might be more prone to urinary bleeding if you have a family history of kidney disease or kidney stones.

Certain medications

Aspirin, nonsteroidal anti-inflammatory pain relievers and antibiotics such as penicillin are known to increase the risk of urinary bleeding.

Strenuous exercise

Long-distance runners are especially prone to exercise-induced urinary bleeding. In fact, the condition is sometimes called jogger’s hematuria. But anyone who works out strenuously can develop symptoms.

Enlarged prostate

Men who have an enlarged prostate are more likely to develop hematuria.

Urinary stones

People diagnosed with urinary stones, may more likely to develop hematuria.

Smoking

Smoking is an important risk factor

DIAGNOSIS

The doctor will do a digital rectal examination to evaluate the health and size of your prostrate. A dipstick urine sample will be tested for any urinary tract infection or the presence of minerals that cause kidney stones.

The following tests and exams play a key role in finding a cause for blood in your urine:

  • Visit to a doctor, which includes physical exam and a discussion of your medical history
  • Urine tests. Even if your bleeding was discovered through urine testing (urinalysis), you’re likely to have another test to see if your urine still contains red blood cells. A urinalysis can also check for a urinary tract infection or the presence of minerals that cause kidney stones.
  • Cystoscopy. Cystoscopy involves passing a thin scope through the urinary tube (urethra) into the bladder to visually inspect the lower urinary system.
  • Imaging tests. Often, an imaging test is required to find the cause of hematuria. Your doctor might recommend a CT or MRI scan or an ultrasound exam.
  • Urine cytology

Sometimes, the cause of urinary bleeding can’t be found. In that case, your doctor might recommend regular follow-up tests, especially if you have risk factors for bladder cancer, such as smoking, exposure to environmental toxins or a history of radiation therapy.

diagnostics

Cystoscopy

diagnostics

Bladder Ultrasound

diagnostics

Lab Test

TREATMENT FOR HEMATURIA

The treatment for blood in the urine is diverse because the underlying conditions drive the medical response. Once the source of the hematuria is identified, the doctor will recommend a course of treatment to address the underlying condition.

Be sure to follow up with your doctor after treatment to ensure there’s no more blood in your urine.

The images and/or videos are not presented as a guarantee of result. The results may vary. Patients gave their consent for the publication of images and/or videos.

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If you need to discuss this sensitive medical concern, schedule a consultation at our clinic in a safe confidential environment. Let us help you achieve optimal health and wellness in a professional setting.

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