Hematuria (Blood in the Urine)

Hematuria (Blood in the Urine)

Overview of Hematuria

Hematuria is also known as blood in the urine, and be very alarming when this occurs. In most cases, blood in the urine can indicate that something very serious is occurring. If you can see the blood in the urine from the naked eye, it is called gross hematuria. On the other hand, if you can only see the blood under the microscope, then it is called microscopic hematuria. It is essential to know the reason behind the bleeding. Your treatment will depend on the cause of bleeding.

Causes of Hematuria

The cause of hematuria is when the kidneys allow blood into the urine. There are many causes of this problem. The most common cause of urine in the blood is a urinary tract infection. A urinary tract infection happens when bacteria enter through the urethra and multiplies in the bladder. The symptoms that you may experience can be pain when urinating, burning with urination, constant urge to urinate, or strong-smelling urine. In older adults, the only sign may be blood in the urine that can only be seen under the microscope.

A kidney infection may also be called pyelonephritis. This occurs when the bacteria enter the kidneys from the bloodstream or it can also move to the kidneys from the ureters. The symptoms are very similar to those of a urinary tract infection.

Kidney stones are also likely in kidney infections. Kidney stones are minerals that form crystals in the bladder of kidneys. They are small and hard, but are painless unless they are causing a blockage or are being passed. Kidney stones cause microscopic bleeding and gross bleeding.

A very rare cause of blood in the urine is exercise. In extreme exercising, a gross hematuria can occur. The cause is not known, but it does seem that it is because of trauma to the organs such as the bladder. It can also be a result of dehydration or breakdown of red blood cells. Runners are the most commonly affected. If you do experience blood in the urine from exercising, then do not assume it is a result of exercising. Speak with your physician.

If you have experienced a kidney injury from an accident or sports, you may experience blood in the urine.

Some medications also are the cause of blood in the urine. In other medications, if you take an anticoagulant and you have a condition that causes the bladder to bleed, then you may also experience blood in the urine.

An enlarged prostate may be a cause of blood in the urine. The prostate gland is located below the bladder and surrounds the top of the urethra. This gland often enlarges with age. Symptoms of an enlarged prostate are urgent need to urinate, difficulty urinating, and blood in the urine.

Some inherited disorders, such as sickle cell anemia or other defects, cause blood in the urine; both microscopic and visible.

Blood in the urine is also caused by cancer. Typically, this is seen in the later stages, so it does not help to detect cancer.

There are several other places that the blood can also be coming from other places when it appears to be coming in the urine. Some other places that it can come from is from the ejaculate in men, vagina in women, or in bowel movements. These things are not something to be worried about, but if you are concerned, call our office. It is better to know the cause and catch the problem earlier than wait and see.

Risk Factors of Hematuria

Nearly everyone can have red blood cells seen in their urine. There are a variety of risk factors that will mean you are more susceptible to hematuria. Age is the first factor. Men over the age of 50 are more likely to have blood in their urine because of the enlarged prostate gland. If you have recently had an infection, then kidney inflammation because of this can lead to urinary blood in children specifically. Long-distance runners or people who go through strenuous exercises are also more likely to develop what is called “jogger’s hematuria”. You are more prone to blood in the urine if you have a family history of any type of kidney disease or stones. Lastly, if you are on any type of medications, then you will be at an increase for urinary bleeding.

Before Your Exam

When you are going through any type of medical diagnosis, it is important to start a notebook. In this notebook, you can write down any concerns, questions, or symptoms that you have. It is very hard to remember what you would like to tell your doctor when you are in your appointment, so take time to think about what you would like to talk about. During your time with the doctor, write down anything that may be important for later. Write down any recommendations that the physician may have.

When to Call our Office

In many cases, blood in the urine is nothing to worry about and may resolve on its own. It is important to call us anytime that you have blood in the urine. This is important so that our physicians can diagnose and treat it as soon as possible. Nearly 20% of patients with blood in their urine are diagnosed with cancer. It is better for our office to go through testing and find out that it is normal than wait and see what another problem may be.

Diagnosis of Hematuria

Your physician will first begin with a physical exam. During this physical exam, your physician will go through your medical history and also your family history. Looking into your family history and your own medical history may open up answers about your diagnosis. Next, you will likely be sent to the lab for testing.

You may be asked to go through a urinalysis, which is a urine test. If the blood was spotted in the urine during a urine test, then you may still be asked to go through another round of testing. This will check to see if there is still blood in the urine and if there are minerals that may cause kidney stones. An imaging test such as an MRI, CT, or ultrasound may be recommended to see the cause of the urine in the blood.

A cystoscopy may also be ordered. During this test, your physician will take a narrow tube with a tiny camera into the bladder for an examination for disease. Sometimes a true diagnosis is not able to be found. When there is no cause of the blood in the urine, then your physician will recommend regular check-ups and testing. This is especially true if you are at a high risk of bladder cancer, like smoking, radiation therapy, or environmental toxins.

Treatment of Hematuria

Treatment of hematuria, or urine in the blood, is depending on the cause of the urine in the blood. If the cause of the urine in the blood is from a urinary tract infection, then your physician will likely prescribe you antibiotics to treat the urinary tract infection. If the cause is an enlarged prostate, then you will likely be prescribed a medication to aid in shrinking the prostate. If the cause is kidney stones, then you may go through shock therapy to help in breaking up the kidney stones.

Prevention of Hematuria

Many cases of blood in the urine are not able to be prevented. For example, there is no way to prevent a urinary tract infection or even cancer. If extreme exercise or medications are the cause of the blood in the urine, then those are preventable. If kidney stones are the cause, then it is important to drink plenty of water. Hydration is the key to preventing the risk of kidney stones in most people. Be sure to eat right and exercise for at least thirty minutes a day. It is important to take care of your body but be sure to not overdo it.

Summary of Hematuria

Blood in the urine, or hematuria, is common and can be caused be a variety of things. There are two types of blood that is found in the urine. The first type of blood is seen by the eye and the other type is the kind that is only seen under the microscope. You will be treated depending on the cause of the blood in the urine. If there is no diagnosis confirmed, then it is extremely important to keep your regular appointments and tests. Blood in the urine is common in about ten percent of the population. Do not panic if you see blood in the urine, however, because in most cases it is easy to be treated. Be sure to call our office as soon as you see blood in the urine. It is better to rule out problems then wait and see what the problem is later down the road. It is essential to treat the diagnosis as soon as possible.

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To request an appointment with Urology, call 251-343-9090. To request an appointment with Radiation Oncology, call 251-414-5665.

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