If you notice blood in your urine, it can be alarming and stressful. However, the cause is harmless in many instances, blood in the urine (hematuria) may indicate a severe urinary disorder.
As many studies show that 24 million Indians suffer from urinary problems.
By itself, hematuria can be the symptom of a rare medical condition. Therefore, ignoring it can lead to the worsening of underlying life-threatening diseases like cancer and kidney disease.
Hematuria is a medical term used for the presence of red blood cells in your urine. If the blood cells are in excess, the urine can become bright red or pink in color.
The blood in your urine may or may not be visible with the naked eye. So hematuria is generally classified into two types.
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Gross Hematuria
When you can clearly see that the urine has turned red or notice the passage of blood clots in urine, it is referred to as gross hematuria.
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Microscopic Hematuria
If your urine appears clear to the naked eye but when seen under a microscope, red blood cells can be identified in your urine, it is called microscopic hematuria. A simple lab test where the urine sample is observed under a microscope can confirm microscopic hematuria. The prevalence of microscopic hematuria in adults ranges from 0.19 to 21 percent.
Who is More Likely to have Hematuria?
Anyone can develop hematuria, but certain people are more likely to develop hematuria. It includes people with :
- A family history of kidney disease
- An enlarged prostate
- A history of kidney stones
- Life-threatening diseases like Cancers of the kidney, bladder, or prostate
- Urinary tract infections
- History of intake of certain medicines such as blood thinners
- Traumatic injury of the kidney, bladder, or urethra
Symptoms And Causes of Blood in The Urine
It is vital to understand that the symptom of blood in urine needs to be evaluated as early as possible. Any blood in urine can indicate a life-threatening condition and needs early diagnosis and management. Gross hematuria generally produces pink, red, or cola-colored urine. It can occur due to the presence of red blood cells in urine. Hematuria can be painless or painful. Painless hematuria is usually seen in cancers of the kidney or bladder while painful hematuria could be either due to infection or blood clots leading to obstruction to the flow of urine. Bloody urine can often occur without other signs or symptoms. Therefore recognizing the early symptom of hematuria, especially the first episode, is important to get timely treatment.
What Causes Hematuria?
There can be multiple causes of the occurrence of blood in the urine. Depending on the site of origin of blood, causes can be classified into
- Urinary causes (True Hematuria)
- Blood from Kidney, Ureters, Bladder, Prostate, Urethra
- Non Urinary causes (False Hematuria)
- Change in color of urine due to intake of medicines or food items
Urinary causes
Infections
Infection in your urinary tract, infections of the kidney, prostate, or urinary bladder can be one of the causes of hematuria. These are more common in women and people in the elderly age group. Moreover, it often causes pain and lowers urinary tract symptoms of increased frequency of urination and inability to hold urine.
Stones
Kidneys stones can also present with blood in the urine. Stones are crystals that can form in the urine and increase in size. Large stones in kidneys may fall in the ureter causing a blockage that often results in hematuria.
Enlarged prostate
In middle-aged or older men, a common cause of hematuria is an enlarged prostate. This gland lies beneath the bladder and surrounding the urethra. When the prostate gets enlarged, it can lead to bleeding inside the urethra which can manifest as blood in the urine. Infection of the enlarged prostate is another common cause of hematuria.
Kidney disease
People with kidney diseases can complain of blood in the urine. This needs evaluation and may be associated with a leak of proteins in urine as well. An inflamed or infected kidney can also lead to blood in the urine.
Cancer
Cancers of the urinary tract often present with painless hematuria. Cancer of the kidneys or ureters can lead to the passage of worm-like clots in urine. Urinary bladder cancer most commonly presents with the passage of amorphous clots and multiple episodes of hematuria. Prostate cancer can also present with blood in the urine in its advanced stage. Passage of clots in urine could be an ominous sign of a life-threatening disease and must be thoroughly evaluated. Identifying the underlying cause of blood in urine can help your doctor to diagnose your condition at the earliest possible and start timely treatment.
How is Hematuria Diagnosed?
You may often ignore blood in urine by considering it as a non-serious issue. However, it should not be ignored. It is vital to immediately contact your healthcare provider if you see blood in the urine or discover a change in the color of urine. Your doctor can ask you certain questions, including:
How often do you urinate?
Do you experience any pain while passing urine?
Are you also passing blood clots during urination?
Are you taking any antiplatelet medications (blood thinners)?
Based on these questions, he can also ask about your medical history and send a sample of your urine for lab tests. This is also known as urinalysis. He might also suggest blood tests or imaging studies understand the problem more accurately. Every patient with hematuria must be evaluated by :
- CT scan: This is a special kind of imaging study (like X-ray) that helps in localizing the cause of blood in the urine. In case of cancer or stones in your bladder, kidney, or ureter, the site and of the disease can be identified by a CT Scan.
- Ultrasound KUB: The test uses sound waves to create a picture of your kidney. Blood clots and bladder masses can be identified using a CT scan. Any hydronephrosis (swelling of the kidney) can also be identified in an ultrasound scan.
- Cystoscopy: In this test, a doctor threads a small flexible tube with a camera mounted on it to inspect your urethra and urinary bladder. Any cancer of the urinary bladder can be identified by this test. The area of the prostate and urethra can also be visualized and any abnormality can be detected.
Treatment to Undertake
Depending on the condition, your doctor might start the treatment by prescribing medications. The information collected by the doctor from the medical history, physical exam, and other tests will help determine the best treatment option. You may require a surgical intervention based on the results of the above-mentioned tests.
Medications
Your doctor may prescribe certain antibiotics to treat infections of the urinary tract. Hematuria caused by Urinary Tract Infections [ UTI] is treated mainly through antibiotics. These antibiotics help kill the bacteria causing UTI.
Hematuria caused by kidney stones can be painful. Hence, a doctor may prescribe medications to pass the stones. Moreover, a procedure called Ureteroscopic Lithotripsy [URSL] can also help in breaking up the stones. This is a stitchless procedure that can help you get rid of kidney stones.
If an enlarged prostate is causing hematuria, your doctor may prescribe medications such as alpha-blockers or 5-alpha reductase inhibitors.
Maintaining an active lifestyle.
Following an active lifestyle is vital to your kidney and bladder health. You can follow the below-mentioned steps for better health:
- Drink plenty of water daily. It is suggested that you should drink at least six to eight glasses of water daily.
- Cutting down on alcohol and caffeinated food can help improve your bladder health.
- Quit cigarette smoking. Read more
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