Blood in the urine is not always indicative of a serious issue, but it is a sign to see a doctor, to make sure. Hematuria is the medical term for bloody urine, and a variety of factors can lead to this event.
Types of Hematuria
There are two types of hematuria. Gross hematuria occurs when the naked eye can see that blood is present in the urine. A patient is diagnosed with microscopic hematuria if blood can only be seen in the urine only with a microscope.
What are the Symptoms of Hematuria?
The only true symptom of hematuria is blood in the urine, which may or may not be visible to the individual. However, the condition causing hematuria will usually cause other symptoms, as well. Some of the most common include painful urination or having to urinate frequently; these are often associated with a urinary tract infection. If hematuria is the symptom of a kidney stone, one might experience moderate to severe abdominal or flank pain. It is possible that these will be the only symptoms.
What Causes Hematuria?
Hematuria occurs when the kidneys or another part of the urinary tract (like the bladder or urethra) allows blood cells to release into the urine. Various factors can cause this event, and the most likely include:
- Urinary Tract Infections or Kidney Infections. An infection of the bladder or urethra occurs in the lower urinary tract. The kidneys or ureters are in the higher urinary tract but are also susceptible to infections that cause hematuria.
- Bladder or Kidney Stones. A hard piece of a mineral can form in the urinary tract, causing blood to leak into the urine. These stones can range from the size of a grain of salt to a couple of inches. Passing the stones can be painful.
- Medications. Some anticoagulants and antibiotics can cause blood in the urine. However, even over-the-counter medications might be enough to cause hematuria in some cases.
- Strenuous Exercise. This cause of hematuria is still quite mysterious, but strenuous exercise has been associated with bloody urine.
More Causes of Hematuria
- An enlarged prostate can push against the urethra and block the stream of urine, at least partially. Both benign prostate hyperplasia and prostate cancer can lead to hematuria.
- Both kidney disease and cancer of the bladder or kidneys can cause hematuria.
- Inherited or hematologic disorders (those affecting the blood or blood-forming organs) can affect the ability of blood to clot, which can lead to hematuria. Sickle cell disease is just one type of hematologic disorder associated with blood in the urine.
- Any type of trauma or injury to the urinary tract might cause blood in the urine.
When to Contact a Doctor
Though not all reasons for hematuria are serious, it is important to contact a doctor when one notices this symptom. Many causes will not require further care and will eventually go away on their own. In the case that it is something more serious, seeing a doctor can allow for early detection and diagnosis of the cause, which means prompt treatment and a better prognosis.
How is Hematuria Tested and Diagnosed?
Multiple tests can determine why there is blood in the urine. The doctor will select the method best suited to the patient, based on the type of hematuria and their other symptoms.
- A urinalysis with microscopic examination will not only spot microscopic hematuria but also reveal evidence of infection including the presence of bacteria or white blood cells. If kidney disease is present, a urinalysis will show it.
- A urine culture identifies the genetic material of microorganisms in the urine, allowing the technician and doctor to properly and precisely determine the infection.
More Hematuria Tests
- A cystoscopy uses a thin tube to examine the inside of both the urethra and bladder. A biopsy (tissue sample) might be taken during a cystoscopy to test for cancer.
- Imaging tests scan the kidneys to identify problems in or around the organ. A CT scan, intravenous pyelogram, or ultrasound can be performed in the upper urinary tract to determine the cause of blood in the urine.
- Blood tests can evaluate kidney function, as well.
What is the Treatment for Hematuria?
If blood in the urine is caused by a temporary, minor problem such as medication, an individual may not require medical care. However, other causes of hematuria do require specific treatment. Doctors prescribe antibiotics for urinary tract infections, and some people with kidney stones require the intervention of a urologist. Lithotripsy or ureteroscopy are two treatments for kidney stones. If hematuria reveals cancer or another serious condition, a doctor will employ various therapies based on the type and stage of the disease.
What is the Prognosis for Hematuria?
Most causes of hematuria have a good prognosis. Medications or minor injuries that cause blood in the urine often clear up on their own. Likewise, urinary tract infections and kidney stones are temporary ailments, although they do require treatment. The earlier a doctor detects cancer or kidney disease, the better the prognosis.
When hematuria is the result of an enlarged prostate or blood disease, preventing it can be difficult. People can help prevent urinary tract infections by keeping well hydrated and adopting certain habits such as urinating immediately after intercourse. Controlling blood sugar, eating healthy, and exercising regularly can help prevent some kidney diseases. Speak to a doctor about other ways to avoid developing hematuria.