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The presence of blood in your urine can be concerning. While the cause is often innocuous, blood in the urine (hematuria) can indicate a serious condition.
Gross hematuria refers to visible blood. When your doctor tests your urine, he or she will find microscopic hematuria (urinary blood visible only under a microscope). In any case, it's critical to figure out what's causing the bleeding.
Treatment is determined by the underlying cause.
WHAT ARE THE SYMPTOMS OF HEMATURIA?
Because of the presence of red blood cells, gross hematuria causes pink, red, or cola-colored urine. It only takes a small amount of blood to produce red urine, and the bleeding is usually not painful. However, passing blood clots in your urine can be painful.
Bloody urine is a common occurrence in the absence of other signs or symptoms.
WHAT ARE THE CAUSES OF HEMATURIA?
Hematuria occurs when your kidneys or other parts of your urinary tract allow blood cells to leak into your urine. This leakage can be caused by a variety of issues, including:
- Urinary tract infections: Bacteria enter your body through the urethra and multiply in your bladder, causing these symptoms. A persistent urge to urinate, pain and burning when urinating, and extremely strong-smelling urine are all symptoms.
For some people, particularly the elderly, the only sign of illness may be microscopic blood in the urine.
- Enlarged prostate: As men get older, the prostate gland, which is located just below the bladder and surrounds the top part of the urethra, enlarges. It then compresses the urethra, obstructing urine flow partially. An enlarged prostate (benign prostatic hyperplasia, or BPH) is characterized by difficulty urinating, an urgent or persistent need to urinate, and either visible or microscopic blood in the urine. The same signs and symptoms can be caused by a prostate infection (prostatitis).
- Infections of the kidneys (pyelonephritis): These can happen when bacteria enter your kidneys from your bloodstream or when bacteria move from your ureters to your kidney (s). The signs and symptoms of kidney infections are often similar to those of bladder infections, though kidney infections are more likely to cause a fever and flank pain.
- A kidney or bladder stone: Concentrated urine contains minerals that can form crystals on the walls of your kidneys or bladder. The crystals can grow into small, hard stones over time.
Because the stones are generally painless, you won't know you have them unless they cause a blockage or are passed. The symptoms are usually unmistakable, kidney stones, in particular, can cause excruciating pain. Stones in the bladder or kidneys can also cause both gross and microscopic bleeding.
- Cancer: Urinary bleeding that is visible may be a sign of advanced kidney, bladder, or prostate cancer. Unfortunately, you may not notice any signs or symptoms in the early stages of these cancers, when they are more treatable.
- Inherited disorders: Sickle cell anemia, a hereditary hemoglobin deficiency in red blood cells, results in blood in the urine, both visible and microscopic hematuria. Alport syndrome, which affects the filtering membranes in the glomeruli of the kidneys, can also occur.
- Kidney disease: Microscopic urinary bleeding is a common symptom of glomerulonephritis, which is an inflammation of the filtering system of the kidneys. Glomerulonephritis can be a complication of another disease, such as diabetes, or it can occur on its own. Viral or strep infections, blood vessel diseases (vasculitis), and immune problems such as IgA nephropathy, which affects the small capillaries in the kidneys that filter blood (glomeruli), can all cause glomerulonephritis.
- Kidney injury: A blow to your kidneys or other injury to your kidneys as a result of an accident or contact sports can result in visible blood in your urine.
- Medications: Cyclophosphamide and penicillin, both anti-cancer drugs, can cause urinary bleeding. If you take an anticoagulant, such as aspirin or the blood thinner heparin, and you also have a condition that causes your bladder to bleed, you may experience visible urinary blood.
- Strenuous exercise: Strenuous exercise rarely causes gross hematuria, and the cause is unknown. It could be caused by bladder trauma, dehydration, or the breakdown of red blood cells that occurs with prolonged aerobic exercise.
Runners are the most commonly affected, but anyone can experience visible urinary bleeding after an intense workout. If you notice blood in your urine after exercising, don't assume it's due to the exercise. Consult your physician.
The cause of hematuria is frequently unknown.
WHAT ARE THE RISK FACTORS FOR HEMATURIA?
Red blood cells can be found in the urine of almost anyone, including children and teenagers. Factors that increase the likelihood of this include:
- Age: Many men over the age of 50 experience hematuria on occasion as a result of an enlarged prostate gland.
- Infection that occurred recently: One of the most common causes of visible urinary blood in children is kidney inflammation following a viral or bacterial infection (post-infectious glomerulonephritis).
- Family history: If you have a family history of kidney disease or kidney stones, you may be more prone to urinary bleeding.
- Certain medications: Aspirin, nonsteroidal anti-inflammatory pain relievers, and antibiotics such as penicillin have all been linked to an increased risk of urinary bleeding.
- Strenuous exercise: Long-distance runners are particularly vulnerable to exercise-induced urinary bleeding. In fact, the condition is also known as jogger's hematuria. Anyone who works out vigorously, on the other hand, is at risk of developing symptoms.
HOW IS HEMATURIA DIAGNOSED?
The following tests and exams are important in determining the cause of blood in your urine:
- Physical exam: A physical exam will be performed, as well as a discussion of your medical history.
- Urine tests: Even if your bleeding was discovered through urine testing (urinalysis), you will almost certainly be subjected to another test to determine whether your urine still contains red blood cells. A urinalysis can also be used to rule out a urinary tract infection or the presence of minerals that cause kidney stones.
- Imaging tests: An imaging test is frequently required to determine the cause of hematuria. A CT or MRI scan, as well as an ultrasound exam, may be recommended by your doctor.
- Cystoscopy: Your doctor inserts a narrow tube with a tiny camera into your bladder to look for signs of disease in the bladder and urethra.
It is not always possible to determine the cause of urinary bleeding. In that case, your doctor may advise you to have regular check-ups, particularly if you have risk factors for bladder cancer, such as smoking, exposure to environmental toxins, or a history of radiation therapy.
HOW IS HEMATURIA TREATED?
Treatment may include taking antibiotics to clear a urinary tract infection, trying a prescription medication to shrink an enlarged prostate, or having shock wave therapy to break up bladder or kidney stones, depending on the cause of your hematuria. In some cases, there is no need for treatment.
Make an appointment with your doctor after treatment to ensure that there is no more blood in your urine.