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Hematuria (Blood in Urine)

What is Hematuria?

Hematuria is a condition characterized by blood in the urine. Hematuria is usually categorized into macroscopic, where the urine is discolored, and microscopic, where blood is found only on a dipstick or microscopic examination. Further, clinically relevant distinctions can be made between painful and painless hematuria and hematuria of glomerular and post-glomerular origin.

Causes of Hematuria

Some of the common causes of hematuria include:

  • Pyelonephritis (kidney infections)
  • Urinary tract infections
  • Kidney or bladder stonesĀ 
  • 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 of Hematuria

Some of the common symptoms of hematuria include:

  • 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

Diagnosis of Hematuria

Hematuria can be diagnosed by:

  • General physical examination, which includes assessment of blood pressure, pulse, prostate in a male, and gynecological organs in a female
  • Urinalysis, which includes urine specimen to check for microscopic red blood cells, white blood cells, and bacteria. 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
  • 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 Hematuria

Treatment typically involves treating the condition causing the hematuria, including:

  • Taking antibiotics to eliminate urinary tract infection
  • Shrinking of the enlarged prostate through prescription medications
  • Use of shock wave therapy to break up kidney or bladder stones
  • Surgical excision of tumors affecting the kidney or bladder

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 instantly post sex, and follow good hygiene
  • To avert stone formation, refrain from excess salt and certain foods like spinach 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: Aspirin, blood thinners, penicillin have been known to increase the risk of blood in the urine
  • Age: Men who are older than 50 are prone to occasional hematuria due to enlarged prostate
  • Recent infection: Viral or bacterial infection of the kidney can cause blood in the urine of children
  • Strenuous exercise: Exercise-induced urinary bleeding can be observed in long-distance runners and is sometimes called Jogger's hematuria