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What is Hematuria?

Blood in the urine is called Hematuria. The blood may be visible, or “Gross Hematuria”, or only detected on a microscope, called “Microscopic Hematuria”. Hematuria is not a normal finding and requires an investigation to rule out dangerous causes.

Causes of Hematuria

Some of the common causes of hematuria include:

  • Pyelonephritis (kidney infections)
  • Urinary tract infections
  • Kidney or bladder stones
  • Kidney disease, such as glomerulonephritis (inflammation of the kidneys' filtering units known as glomeruli)
  • Enlarged prostate, as a result of BPH, prostatitis, or aging
  • Kidney injury, as a result of accident or contact sports
  • Cancer of the kidney, bladder, or prostate
  • Inherited disorders, such as sickle cell anemia

Symptoms associated with Hematuria

While experiencing hematuria, you may also be experiencing other symptoms. These symptoms can help determine what condition is causing the hematuria.

  • Difficulty in urination
  • Pain and burning with urination
  • Pain in the lower back, sides, or groin that often comes and goes
  • Frequent urge to urinate
  • Bleeding
  • Cloudy and foul-smelling urine
  • Fever

Evaluation of Hematuria

Hematuria always requires an appropriate evaluation. This may include:

  • General physical examination, which includes assessment of blood pressure, pulse, prostate in a male, and gynecological organs in a female
  • Urinalysis, which includes a group of tests to analyze substances in a urine specimen such as red blood cells, white blood cells, bacteria, and others. A urinalysis can also check for urinary tract infection and the presence of crystals, ova, or parasites
  • Blood tests to check for full blood count with an erythrocyte sedimentation rate. Serum urea, creatinine, and electrolytes should be measured, along with albumin, calcium, and liver function tests if you are unwell or in renal failure
  • Ultrasound
  • CT scan
  • MRI scan
  • Flexible cystoscopy that involves the insertion of a lighted long tube with a camera through the urethra to inspect your bladder
  • Transurethral biopsy that involves the removal of a part of tissue for examination in the lab

Treatment of the causes Hematuria

Treatments for the causes of hematuria are as diverse as the conditions themselves:

  • Antibiotics for infections
  • Medications or surgery to manage an enlarged prostate
  • Medications or surgery to manage kidney or bladder stones
  • Surgery for treatment of a cancer
  • Therapies for management of chronic inflammatory conditions such as radiation cystitis

Prevention of Hematuria

Hematuria can be prevented by preventing the underlying causes:

  • To avert bladder cancer, abstain from smoking, restrict your exposure to chemicals, and consume lots of water
  • To avert infections, consume plenty of water, urinate following sexual intercourse (for women) , and follow good hygiene
  • To avert stone formation, refrain from excess salt, eat a healthy diet including fruits and vegetables,and consume plenty of water

Risk Factors for Hematuria

Some of the factors that make hematuria more likely include:

  • Family history: You are prone to hematuria if you have a familial history of kidney stones or kidney disease
  • Certain medications: Some medications such as blood thinners or excessive pain medication use can increase your risk of hematuria
  • Age: Men who are older than 50 are prone to occasional hematuria due to enlarged prostate
  • Recent infection: Viral or bacterial infection of the kidneys
  • Strenuous exercise: Exercise-induced urinary bleeding can be observed in long-distance runners and is sometimes called Jogger’s hematuria

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