Hematuria (blood in the urine)
Hematuria is the presence of blood in the urine. This can be visible by you or only found on a urine test (microscopic). No matter what type is found, it should be evaluated by a urologist. Normally your kidneys should not leak any blood while making urine. If there is blood in the urine, this could signal a kidney function abnormality or some type of problem downstream from the kidneys that is causing blood.
Hematuria can be seen by the naked eye (gross hematuria) or only found under a microscope (microscopic hematuria). Most of the time there is no pain associated with this. Either way it is important to do testing to rule out any serious condition. Most of the time the cause for the blood is not life threatening, but blood in the urine is the most common sign we find for many types of urologic cancers such as kidney and bladder cancer. Dr. Shaba can guide you thru these tests and explain the findings.
Symptoms:
Depending on the underlying cause of your hematuria, you may or may not have any symptoms. Below are some conditions and symptoms you may see.
- Burning with urination- may be a sign of an infection or even bladder cancer
- Pain in the abdomen or back- may be a sign of a kidney stone or infection
- Difficulty with urination- could be a sign of an enlarged prostate, infection, or inflammation
- No symptoms- sometimes you just see blood without any symptoms. Could be anything from kidney dysfunction, a small stone, a large prostate, or cancer in the urinary tract.
Risk Factors:
- Recent Infection
- History of stones
- BPH- large prostate in men
- Medications- Blood thinners such as Warfarin, Plavix, Xarelto and others. As well as aspirin, anti-inflammatory pain relievers, and even some supplements like fish oil that thin the blood.
- Strenuous exercise- Weight lifters or long-distance runners
Causes:
Most of the causes of hematuria are not serious and are not life threatening. However, it could be the only sign of a cancer or other serious underlying conditions… this is why it is important to never ignore blood in the urine. See your doctor. Here is a list of common causes:
- Infections in the urinary tract- kidney or bladder. And in men, prostate
- Stones in the urinary tract- kidney, ureter or bladder
- Enlarged prostate in men
- Cancer- kidney, ureter, bladder or urethra. Prostate in men
- Medical kidney disease
- Trauma or injury to the kidney or any part of the urinary system
- Congenital defects or abnormalities in the urinary tract
- Medications
- Strenuous exercise
- And sometimes we cannot find any reason
Evaluation:
All episodes of hematuria should be evaluated by a urologist. Whether it is one drop of blood, a toilet full of blood, or your doctor tells you there is microscopic blood (not visible to the naked eye). Any of these scenarios could be your only sign of cancer or another serious condition.
Cystoscopy- a small flexible camera that goes thru the urethra into the bladder. Usually done in the office with local anesthesia but can be done with nitrous gas or anesthesia depending on the situation. Takes 2 minutes to do. No test is a substitute for this.
Cytology- a urine test to look under a microscope for any unusual or cancer cells
Imaging- Usually a CT scan done with and without IV contrast which concentrates on the kidneys and ureters. Sometimes an ultrasound is substituted due to allergies or kidney function
For more information please visit: https://www.urologyhealth.org/urology-a-z/h/hematuria
