Hematuria
Hematuria is blood in the urine.
Generally, this condition is divided into two categories: “gross” or “visible” hematuria or “microscopic” hematuria.
When the urine is red or pink and linked to blood in the urine, this is called “gross” or “visible” hematuria.
When blood is in the urine but is not easily seen or can only be seen under a microscope, it is called “microscopic” hematuria.
Causes
Blood in the urine may have several causes. Most are not of concern, but some causes may require attention from your healthcare provider.
Common causes of hematuria include the following:
- Urinary infection
- Enlarged Prostate in older men
- Kidney or bladder stones
- Menstrual period in women
- Prostate infection
- Kidney disease
- Kidney trauma
- Bladder cancer (mostly in smokers)
- Kidney cancer
- Cancer of the lining of the urinary tract
- Anti-swelling drugs (joint swelling and pain pills)
- Strenuous workout
Diagnosis
A urine sample will be needed for testing during a visit to your healthcare provider. Blood might be found either using a chemical strip (called a dipstick) or under a microscope.
Your doctor may want to conduct an exam and review your full health record to see if you have risks for cancer such as smoking, prior radiation, chemotherapy or environmental exposures.
If nothing is found to explain the blood in the urine, then your doctor may assess your level of risk for cancer as low, intermediate or high.
Additionally, your doctor will be looking for non-cancer causes for the blood in the urine, such as recent trauma, a urinary tract infection (UTI) or other procedures.
All patients with blood visible in their urine (“gross hematuria”) are at high risk.
Testing
Your healthcare provider may order testing first to determine if there is an abnormality of the bladder and secondly to evaluate the upper urinary tract.
Cystoscopy is a procedure using a fiberoptic camera to view the inside of the bladder and urethra to find causes of bleeding or blockage or any abnormalities of the bladder and its lining.
Imaging such as an ultrasound or CT scan are used to review the upper urinary tracts — the kidneys and ureters, which are the tubes that carry the urine to the bladder.
Treatment
Treatments depend on the underlying cause of blood in the urine.
If an infection or other disease (kidney disease, sickle cell) is found, your healthcare provider may prescribe an antibiotic or other appropriate medications.
If no cause is found or known, your doctor may order more tests in six months.
If the cause is cancer, your provider will conduct treatment appropriate for the stage and level of the disease.