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Why Is There Blood in My Urine (Hematuria)

Overview

Hematuria is the presence of blood in your urine.

Many different conditions and diseases can lead to hematuria. These include infections, kidney disease, cancer, and rare blood disorders. The blood may be seen or in such small quantities that it can’t be visible with the naked eye.

Any blood in the urine can be a sign of a serious health issue, even if it happens only one time. Ignoring hematuria can worsen the serious conditions like cancer and kidney disease, so you should consult your doctor as soon as possible.

Your doctor can examine your urine and perform imaging tests to determine the cause of the hematuria and make a plan for treatment.

What are the types of hematuria?

There are two major types of hematuria: gross hematuria and microscopic hematuria.

Gross hematuria

If there is enough blood in your urine that spots can be visible with your naked eye or urine appears pink or red in color, you have “gross hematuria.”

Microscopic hematuria

When you can’t see the blood in your urine because the quantity is too small, you have “microscopic hematuria.” Only a lab test that detects blood or looking at a sample of urine under a microscope can prove microscopic hematuria.

What causes hematuria?

There are many potential causes for hematuria. In some cases, the blood may be from a different source.

Blood can appear to be in the urine when it’s actually coming from the vagina in women, the ejaculate in men, or from a bowel movement in either men or women. If the blood is truly in your urine, there are various possible causes.

Infection

Infection is one of the most usual causes of hematuria. The infection could be present in your urinary tract, your bladder, or in your kidneys.

Infection occurs when bacteria move up the urethra, the tube that removes urine out of the body from the bladder. The infection can proceed into the bladder and even into the kidneys. It usually causes pain and frequent urination. There may be gross or microscopic hematuria.

Stones

Another common reason for blood in the urine is the presence of stones in the bladder or kidney. These are crystals that form from the minerals in your urine. They can develop inside your kidneys or bladder.

Large stones can cause a blockage that often results in hematuria and significant pain.

Enlarged prostate

In men who are middle-aged and older, a fairly common cause of hematuria is an enlarged prostate. This gland is just beneath the bladder and near the urethra.

When the prostate gets enlarged, as it generally does inmiddle aged male, it compresses the urethra. This leads to problems with urination and may prevent the bladder from emptying completely. This can lead to a urinary tract infection (UTI) with blood in the urine.

Kidney disease

A less common reason for appearance blood in the urine is kidney disease. A diseased or inflamed kidney can lead to hematuria. This disease can occur on its own or as part of another disease, such as diabetes.

In children of 6 to 10 years of age, the kidney disorder post-streptococcal glomerulonephritis may lead to hematuria. This disorder can develop one to two weeks after an untreated strep infection. Once common, it’s rare today because antibiotics can quickly cure strep infections.

Cancer

Cancer of the bladder, kidney, or prostate can also lead to blood in the urine. This is a symptom that usually occurs in advanced cancer cases. There may not be earlier signs of a problem.

Medications

Certain medications can cause hematuria. These include:

Less common causes

There are a few other causes of hematuria that aren’t so common. Rare blood disorders such as sickle cell anemia, Alport syndrome, and hemophilia can also leads to appearance of blood in the urine.

Strenuous exercise or a blow to the kidneys can also lead to blood to be visible in the urine.

How is the cause of hematuria diagnosed?

If you’re visiting your doctor for the hematuria, they’ll ask you about the amount of blood and when you see it during urination. They’ll want to know how frequently you urinate, any pain you’re experiencing, if you are detecting blood clots, and what medications you’re taking.

Your doctor will then perform physical examination and take a sample of your urine for testing. Your urine examination can confirm the presence of blood and detect bacteria if an infection is the cause.

Your doctor may order some imaging tests like a CT scan, which uses radiation to make an image of your body.

Another possible test your doctor may want to perform is a cystoscopy. In this test, a small tube is used to send a camera up your urethra and into your bladder. With the camera, your doctor can inspect the interior of your bladder and urethra to determine the cause of your hematuria.

When should I seek medical attention?

Since some of the causes of blood in the urine are serious, you should go for the medical attention as Soon as possible, after the first time you see it. You shouldn’t ignore even a small amount of blood in your urine.

Also visit to your doctor or healthcare provider if you don’t see blood in your urine but experience frequent, difficult, or painful urination, abdominal pain, or kidney pain. These may all be indications of microscopic hematuria.

Take urgent help if you are unable to urinate, see blood clots when you urinate, or have blood in your urine along with one or more of the following symptoms:

  • nausea
  • vomiting
  • fever
  • chills
  • pain in your side, back, or abdomen

How is hematuria treated?

The cause of your hematuria will determine what type of treatment you get.

If an infection, such as a UTI, is the cause of your hematuria, your healthcare provider will recommend antibiotics to kill the bacteria causing the infection.

Hematuria caused by large kidney stones can be painful if not treated. Prescription medications and treatments can help you release stones.

Your healthcare provider may recommend using a procedure called extracorporeal shock wave lithotripsy (ESWL) to split up the stones.

ESWL involves using sound waves to break the kidney stones into very small pieces that can pass in your urine. The procedure generally takes around one hour and may be performed under light anesthesia.

Your doctor may also use a scope to remove your kidney stones. To perform this procedure, they pass a thin tube called a ureteroscope through your urethra and bladder into your ureter. The scope is equipped with a camera to locate the stones.

Your healthcare provider will use special tools to trap the stones and remove them. If the stones are large, they will be broken into smaller pieces before removal.

If an enlarged prostate is causing your hematuria, your healthcare provider may recommend medication, such as alpha blockers or 5-alpha reductase inhibitors. In some cases, surgery may be an option.

What are the complications associated with hematuria?

Some of the causes of blood in the urine are serious, so you should consult your healthcare provider if you experience this symptom.

If the symptom is because to cancer, ignoring it can cause an advancement of the tumors to the point that treatment is difficult. Untreated infections can finally lead to kidney failure.

Treatment can help lowering of symptoms if the cause of hematuria is an enlarged prostate. Ignoring it may cause discomfort from urgency to urinate frequently, severe pain, and even cancer.

How can I prevent hematuria?

Preventing hematuria means preventing the underlying causes:

  • To prevent infections, drink enough water daily, urinate immediately after sexual intercourse, and maintain good hygiene.
  • To prevent stones, drink lots of water and avoid excessive salt and certain foods like spinach and rhubarb.
  • To prevent bladder cancer, avoid smoking, control your exposure to chemicals, and drink lots of water.

Sources:

Serum Hemoglobin Test

Necrotizing Fasciitis (Soft Tissue Inflammation)