Hematuria
Hematuria refers to blood in the urine. If the patient can see blood in the urine, then it’s called gross hematuria. Urinary blood that’s only visible under a microscope (called microscopic hematuria) is found during a urine test. Patients will need further testing to identify the cause of hematuria.
Symptoms of Hematuria
Patients with gross hematuria have pink, red, or cola-colored urine due to the presence of red blood cells. It doesn’t require much blood to produce red urine and the bleeding typically isn’t painful. However, passing blood clots in the urine may be painful.
Patients with bloody urine often don’t have any other signs or symptoms.It’s important to seek medical attention for signs of blood in the urine to rule out serious illnesses or conditions.
Causes of Hematuria
Hematuria occurs when the kidneys or other parts of the urinary tract allow blood cells to leak into urine. This can occur due to:
Urinary tract infection (UTI): When bacteria enter the body through the urethra and multiply in the bladder, the individual will experience symptoms of UTI; these can include pain and burning during urination, a persistent urge to urinate, and foul-smelling urine.
Kidney infections (pyelonephritis): When bacteria enter the kidneys from the bloodstream or move from the ureters to the kidney(s), individuals may experience signs and symptoms similar to bladder infections. However, kidney infections are more likely to cause flank pain and fever.
- A bladder or kidney stone: A bladder or kidney stone forms when the minerals in concentrated urine harden on the walls of the kidneys or bladder, becoming small, hard stones. Bladder or kidney stones can cause both gross and microscopic bleeding.
- Enlarged prostate: An enlarged prostate gland can compress the urethra, partially blocking urine flow, leading to visible or microscopic blood in the urine.
- Kidney disease: Kidney disease can cause microscopic urinary bleeding. The condition may be part of a systemic disease, such as diabetes, or it can occur on its own.
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- Cancer: Advanced kidney, bladder or prostate cancer can cause visible hematuria.
- Other causes: Sickle cell anemia, Alport syndrome, kidney injury, medications, and strenuous exercise can all cause hematuria.
In some cases, the cause of hematuria can’t be identified.
Risk Factors of Hematuria
Certain factors increase the risk of developing hematuria, including:
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- Being male over the age of 50 and having an enlarged prostate
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- Recent infection
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- Family history of kidney disease or kidney stones
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- Taking aspirin, antibiotics, and non-steroidal anti-inflammatory pain relievers
- Engaging in strenuous exercise
Diagnosis of Hematuria
To identify the cause of hematuria, the following tests and exams may be performed:
- Physical exam and discussion of medical history
- Urine test to check for UTI and kidney stones
- CT, MRI, or ultrasound exam
- Cystoscopy to examine the bladder and urethra for signs of illness