What is blood in the urine (hematuria)?
Hematuria is blood in the urine or the presence of blood cells in the urine. Although hematuria can sometimes be seen with the naked eye, it is sometimes only seen with a microscope:
- Macro hematuria: In the case of bleeding that leaves clearly visible traces of blood in the urine, it is necessary to mention a case of macro hematuria. Depending on how much blood is in the urine, the color can be pink, red, dark red or brown.
- Micro hematuria: Blood in the urine is difficult to see with the naked eye. Sometimes the urine can look completely normal, even though the ratio of red blood cells is alarmingly high. This so-called microhematuria is only revealed by a microscopic examination.
Several different conditions and diseases can cause hematuria. These include infections, kidney disease, cancer, and rare blood disorders. The blood may be visible to the naked eye or in amounts too small to be seen with the naked eye.
Any blood in the urine, even just once, can be a sign of a serious health problem. Ignoring hematuria can lead to worsening of serious conditions such as cancer and kidney disease, so you should talk to your doctor as soon as possible.
Your doctor may analyze your urine and request imaging tests to determine the cause of hematuria and create a treatment plan.
What causes blood in the urine (hematuria)?
In hematuria, your kidneys or other parts of your urinary tract allow blood cells to leak into the urine. Various issues can cause this leak, including:
urinary tract infections
A urinary tract infection occurs when bacteria enter your body through the urethra and multiply in your bladder. Symptoms can include a constant urge to urinate, pain and burning when urinating, and an overly strong-smelling urine. For some people, especially older adults, the only sign of illness may be microscopic blood in the urine.
These can occur if bacteria enter your kidneys through your bloodstream or pass through your ureters to your kidneys. Signs and symptoms are often similar to bladder infections, but kidney infections are more likely to cause fever and lower back pain.
Bladder or kidney stone
Minerals in the urine sometimes form crystals in the walls of your kidneys or bladder. Over time, the crystals can become small, hard stones. Stones are usually painless, so you probably won’t know you have them unless they’re causing a blockage. Kidney stones, in particular, can cause excruciating pain. Bladder or kidney stones can cause both macrohematuria and microscopic hematuria.
The prostate gland, which is just below the bladder and surrounds the upper part of the urethra, usually enlarges as men approach middle age. It then compresses the urethra, partially blocking the flow of urine. Symptoms of an enlarged prostate ( benign prostatic hyperplasia ) include difficulty urinating, an urgent and constant need to urinate, or microscopic blood. A prostate infection can cause the same signs and symptoms.
Microscopic hematuria 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 may occur on its own. Viral or strep infections, blood vessel diseases, and immune problems such as nephropathy , which affects the small capillaries that filter blood in the kidneys, can trigger glomerulonephritis.
If blood from the urine is visible, it may be a sign of advanced kidney, prostate, or bladder cancer. Unfortunately, in the early stages, when these cancers are more treatable, you may not have signs or symptoms.
Sickle cell anemia (an inherited hemoglobin defect in red blood cells) causes blood in the urine, which is both visible and microscopic hematuria. Alport syndrome , which affects the filtering membranes in the glomeruli of the kidneys , can also cause blood in the urine.
If you have suffered a blow or other injury to your kidneys from an accident or contact sports, this can cause visible blood in your urine.
The anti-cancer drugs cyclophosphamide and penicillin can cause urinary bleeding. Sometimes bloody urine also occurs if you take a medicine such as aspirin and the blood-thinning heparin and you have a condition that causes your bladder to bleed.
It is rare for strenuous exercise to cause hematuria and the cause is unknown. It may be linked to the breakdown of red blood cells brought on by bladder trauma, dehydration, or sustained aerobic exercise. If you see blood in your urine after exercise, it’s a good idea to see your doctor.
Blood in the urine (hematuria) and what are the accompanying symptoms?
While blood in the urine is not always a sign of serious illness, in some cases it can be an important warning sign of a potential health problem. Blood in the urine should never be ignored.
You should contact your doctor right away if you have blood in your urine, especially if you suffer from any of the following:
- painful urination
- Frequent and urgent need to urinate
- Stomach ache
In particular, micro hematuria may not manifest itself with any symptoms.
When should you see a doctor?
Because some causes of blood in the urine are serious, you should seek medical attention the first time you see it. You should not ignore even a small amount of blood in your urine.
Also, see your doctor if you don’t see blood in your urine, but you experience frequent, difficult, or painful urination, stomachache, or kidney pain . These can all be signs of microscopic hematuria.
You should see a doctor if you are unable to urinate, have blood in your urine, and experience one or more of the following:
- Back pain
- pain in the sides
How is blood in the urine (hematuria) diagnosed?
If there is blood in the urine, your doctor will ask you questions about your health history and perform a physical examination. This helps your doctor better understand your symptoms.
Then, your doctor may also ask you to have other tests, depending on the situation. These tests usually include:
- Urinalysis: A test is done on a urine sample.
- Urine culture: A urine test that checks for an infection.
- Urine cytology: A urine test that checks for abnormal-looking cells.
- Cystoscopy : It is a diagnostic method with a test device called a cytoscope to look inside the bladder and urethra.
- Computed tomography : Computed tomography is a test that uses X-rays and a computer to create cross-sectional images of the abdomen and pelvis.
How is blood in the urine (hematuria) treated?
The cause of your hematuria will determine what type of treatment you will receive. If an infection, such as a urinary tract infection, is responsible, your doctor will prescribe antibiotics to kill the bacteria causing the infection .
Hematuria caused by large kidney stones can be painful if left untreated. Prescription medications and treatments can help you shed stones.
Your doctor may recommend using a procedure called extracorporeal shock wave lithotripsy to break up stones . This procedure involves using sound waves to break up kidney stones into small pieces that can pass through your urine. The procedure usually takes about an hour and can be done under light anesthesia.
If prostate enlargement is causing hematuria, your doctor may prescribe medications such as alpha blockers or 5-alpha reductase inhibitors . In some cases, surgery may also be an option. Apart from these, it is possible for you to receive many possible treatments depending on the cause.
Remember, your doctor will decide which medicine to take and how.
How to prevent blood from urine?
Preventing hematuria means preventing the underlying causes. These include:
- To prevent infections, drink plenty of water every day, urinate and clean up immediately after sexual intercourse.
- Again, drink plenty of water and avoid certain foods such as excess salt, spinach and rhubarb to prevent stones.
- To prevent bladder cancer, avoid smoking, avoid exposure to chemicals, and drink water often.