What is Blood in the Urine (Hematuria)
Health A-Z

Cause and Treatment of Blood in The Urine

The condition of blood in the urine is called hematuria. The presence of visible blood in the urine is called macroscopic hematuria. Microscopic hematuria is the presence of blood in the urine that cannot be seen with the naked eye but can be detected in laboratory examination.The condition of blood in the urine is called hematuria. The presence of visible blood in the urine is called macroscopic hematuria. Microscopic hematuria is the presence of blood in the urine that cannot be seen with the naked eye but can be detected in laboratory examination.

What is Blood in the Urine (Hematuria)
What is Blood in the Urine (Hematuria)

What is Blood in the Urine (Hematuria)?

Blood in the urine, or hematuria, can occur due to many different reasons. Blood in the urine can indicate a serious health problem. For this reason, if blood is seen in the urine even just once, a doctor should be consulted. There may be enough blood in the urine that can be detected with a microscope, even if it is not visible to the naked eye. This situation can only be determined by urinalysis.

Urine with blood in it; It can be pink, red or cola in color. A small amount of blood is enough to change the color of the urine. Bleeding is usually not painful, but passing a blood clot into the urine can be painful. Hematuria may be seen together with other signs and symptoms in patients.

What Causes Blood in the Urine (Hematuria)?

Hematuria occurs when red blood cells leak from the kidney into the urine. Conditions that can lead to hematuria:

  • Urinary Tract Infections: Bacteria can enter the body through the urethra, the part where urine comes out, and cause an infection. Symptoms seen in urinary tract infection; the need to urinate frequently, pain and burning during urination, and foul-smelling urine. Microscopic hematuria may be the only sign of urinary tract infection, especially in older people.
  • Kidney Infections (Pyelonephritis): Bacteria entering the urinary tract from the urethra can cause infection in the kidney. In some cases, bacteria can also reach the kidney through the blood. The symptoms of pyelonephritis are similar to the symptoms of urinary tract infection. In pyelonephritis, patients may additionally experience fever and flank pain.
  • Kidney Stone: Minerals in the urine can be concentrated and crystallized in the kidney and bladder wall. Over time, these crystals harden and become stones. Most of the stones are thrown out of the body with urine without causing pain. However, stones that cause obstruction in the urinary tract or that are too large to travel in the urinary tract may cause pain. These stones can cause both macroscopic (visible) and microscopic hematuria in patients. Kidney stones are the first thing that comes to mind in patients with complaints of inguinal pain and blood in the urine.
  • Prostate Enlargement: The prostate is an organ located just below the bladder and surrounds the first part of the urethra. The prostate begins to grow in men, especially after the age of 40. The enlarged prostate can press on the urethra and prevent urine output to a certain extent. Benign prostatic enlargement (Benign Prostatic Hyperplasia, BPH); It causes symptoms such as difficulty urinating and frequent urination. BPH comes to mind when there is blood in the urine in men.Prostatitis, an infection of the prostate gland, can cause similar symptoms.
  • Kidney Disease: The part of the kidneys that allows the kidneys to perform their filtering function is called the glomerulus. The glomerulus structure can become inflamed due to many reasons and this condition is called glomerulonephritis. Systemic diseases such as diabetes, viral infections, vasculitides and immune system problems can lead to glomerulonephritis. Microscopic hematuria is a common symptom in glomerulonephritis.
  • Cancer: Kidney, bladder and prostate cancers can cause visible bleeding in the urine in advanced stages. The mentioned cancers may not cause any symptoms in the early period. This makes it difficult to detect cancer at an early stage and start its treatment.
    Genetic Diseases: Sickle cell anemia is a genetic disease that causes disfigurement in red blood cells. This disease can cause both microscopic and macroscopic hematuria in the urine.The glomerulus structures, which perform the filtering function of the kidney, may also be affected by Alport syndrome, which is a genetic disorder. Blood in the urine may be seen in patients with Alport syndrome.
  • Kidney Injury: In cases such as accidents, sports injuries, the kidney may be seriously damaged and blood may be seen in the urine.
  • Some Medications: Cyclophosphamide, used to treat cancer, and penicillin, an antibiotic, can cause hematuria. The use of blood thinners (anticoagulants) such as aspirin, heparin, and conditions that may cause bleeding in the bladder may also cause blood in the urine.
  • Heavy Exercise: Heavy and strenuous exercise can cause macroscopic hematuria. Although the underlying mechanism of this condition is not fully understood, events such as trauma to the bladder during exercise, dehydration (lack of fluid), or red cell destruction due to prolonged aerobic activities can cause blood to leak into the urine. Hematuria due to heavy exercise is especially seen in horses. However, it should not be forgotten that hematuria can be seen in anyone who does heavy exercise. People who see blood in their urine after exercise; This situation should not be ignored by assuming that it is related to sports, and one should definitely consult a doctor.

In women during menstrual periods, blood in the urine and the mixing of menstrual blood in the urine can be confused with each other. In order to prevent confusion, it should be checked whether the complaint of hematuria continues after women’s menstrual periods are over.

How is the Diagnosis and Treatment of Hematuria?

It is very important in terms of treatment to determine the cause of blood in the urine. For this reason, various tests are performed to find the underlying cause of the patient who applies to the doctor with the complaint of blood in the urine.

For diagnosis, first of all, the patient’s medical history is questioned and it is checked whether there is a history of a disease that may cause hematuria. Then, the patient is examined and physical findings related to the disease are tried to be determined.

Urinalysis is very important in the diagnosis of hematuria. Urinalysis is used to detect conditions such as infection and kidney stones in the patient who comes with the problem of blood coming from the urine. Microscopic hematuria may occur as a result of a urine test performed in patients with another complaint.

In patients with hematuria, urinalysis can also be performed to understand whether bleeding continues.

Imaging methods such as ultrasound, CT, and MRI can be helpful in diagnosing the underlying condition of hematuria.

Cystoscopy is a procedure in which a thin tube with a camera at the end is advanced from the urethra to the bladder. With this procedure, it is evaluated whether there are signs of the disease in the urethra and bladder.

Kidney biopsy, that is, taking sample tissue from the kidney and examining it, is used in the diagnosis of diseases such as glomerulonephritis.

Treatment of hematuria varies according to the cause of bleeding.

If the cause of blood in the urine is urinary tract infection, the patient is given antibiotic treatment. If the cause is a kidney stone, drugs are used to reduce the patient’s pain and help the stone pass through the urinary tract more easily. The stone breaking process known as ESWL (Extracorporeal Shock Wave Lithotripsy) is also a method that can be preferred in the treatment of kidney stones. In this method, large kidney stones are divided into small pieces using sound waves. The ESWL procedure is performed while the patient is under light anesthesia and usually takes about an hour.

  • Both drug therapy and surgical intervention are among the treatment options for prostate enlargement.
  • Some diseases that cause blood in the urine are preventable. To prevent these diseases, the following can be done:
  • In order to prevent urinary tract infections, plenty of fluids should be consumed, urination should be done immediately after sexual intercourse and hygiene rules should be observed.

In order to prevent kidney stone formation, excessive salty foods, spinach and beet consumption should be limited.
To reduce the risk of prostate cancer, it should be ensured that enough fluid is consumed and smoking should be stopped if used.
hematuria; It can occur due to many different reasons, from infection to cancer, from prostate enlargement to kidney stones. People who have complaints of blood in the urine should apply to the nearest health institution without wasting time and have the necessary tests done.

See more information please visit https://en.wikipedia.org/wiki/Hematuria

Bibliography: https://www.medicalpark.com.tr/idrardan-kan-gelmesi/hg-2526

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