Danielle has a PhD in Natural Resource Sciences and a MSc in Biological Sciences
Overview of Hematuria
Joe was just in a car accident and rushed to the hospital even though he only thought he had a few bumps and bruises. Luckily, they kept him overnight because while he was there, he realized his urine had turned pink in color; definitely not the norm. So what happened to Joe? He's experiencing hematuria.
Hematuria is a condition where there is blood in the urine. If this happens, it may be nothing to worry about or it may be a sign of a serious condition, because hematuria is a symptom of another condition or disorder rather than a condition in and of itself.
If blood in the urine is visible with the naked eye, meaning the urine is pink or red in color due to the red blood cells present, like in Joe's case, this is called gross hematuria. When blood is only visible when looked at under a microscope, meaning the urine looks normal with the naked eye, this is called microscopic hematuria. A person with microscopic hematuria may not even realize anything is wrong until they have a urine test performed.
Causes & Symptoms of Hematuria
A number of different conditions can cause hematuria, and each might have slightly different symptoms, which include blood in the urine, or no symptoms at all. Sometimes hematuria is minor enough where no treatment is necessary, but if it's caused by a serious condition, it needs to be addressed. Let's take a look at some of these possible causes.
- Urinary tract infection: This is a bacterial infection that occurs somewhere in the urinary tract. It causes the person to feel like they need to urinate frequently, even if very little urine is produced. It also causes painful or burning urination and produces very strong-smelling urine. It can usually be treated with an antibiotic.
- Kidney infection (pyelonephritis): This is a bacterial infection in the kidneys themselves. The symptoms affiliated with pyelonephritis are similar to those of a urinary tract infection but can also cause back pain and a fever. These can also be treated with antibiotics.
- Bladder and kidney stones: This is a condition where solids form in the material and the kidneys filter out the blood. When this happens, there is still only one way out of the body, but if the stone is large enough, it can get stuck along the way or cause irritation along the various parts of the urinary tract. These are extremely painful, as anyone who has experienced them can attest. If they don't pass on their own, they can be targeted with an external therapy that tries to break the stone up into smaller, passable pieces.
- Enlarged or infected prostate: As men age, their prostate naturally grows in size. This can put pressure on the surrounding tissues, including the urinary tract and cause a frequent urgency to urinate or trouble urinating.
- Kidney disease (such as glomerulonephritis): This is inflammation in the portion of the kidneys that do the filtering. Microscopic hematurias are most common in this scenario.
- Kidney or bladder cancers: Tumors can cause hematuria and are generally treated with chemotherapy or radiation therapy. Cancers in their early stages may not have any symptoms.
- Blood clotting disorders: Hemophilia is one blood clotting disorder that may cause hematuria.
- Trauma to the kidneys: An injury to the kidneys can cause blood to end up where it shouldn't be, such as in the urine. Because our friend Joe was just in an accident, it's probable that there is internal damage that caused blood to get into his urine. Thankfully, he's already in the hospital so doctors can address the situation quickly.
- The use of certain medications: blood thinners, aspirin, or antibiotics may cause hematuria.
- Strenuous exercise (especially running): Though not common, excessive exercise can cause hematuria.
Diagnosing & Treating Hematuria
There is no treatment specific to hematuria; it's more a matter of identifying and treating the condition or disease that is causing it. Treating the underlying condition usually treats the hematuria.
If hematuria occurs, a physical exam and a urine test (urinalysis) are the first two diagnostic procedures a doctor will most likely perform. For example, finding white blood cells in the urine may indicate a urinary tract infection, while finding excess proteins in the urine may indicate kidney disease.
Imaging tests may be used to see if an injury is visible. A dye can be injected into the blood and travel down to the kidneys; this makes the urine visible on a scan like an X-ray. Biopsying the kidney (sampling a small piece of tissue and analyzing it) can also identify possible infections or diseases.
A cytoscopy is a procedure where a small tube with a camera on the end is fed up the urethra to the bladder. It allows the doctor to take a look at the bladder and urethra to look for any signs of damage or possible causes. Trauma, like the kind Joe experienced, require monitoring and possible surgical intervention to stop any internal bleeding.
Hematuria is a condition where there is blood in the urine. It might be visible blood or discoloration, gross hematuria, or only apparent under a microscope, microscopic hematuria. There are many possible causes of hematuria, not all of which require treatment. The most common causes are a urinary tract infection, kidney infection or disease, bladder or kidney stones, cancer, trauma, or use of certain medications. Treating the underlying cause usually resolves the hematuria, and finding the cause can be done through physical exams, biopsies, urinalysis, imaging tests, or cytoscopy, which is a procedure where a small tube with a camera on the end is fed up the urethra to the bladder.
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