|
Metro Urology
What is blood in the urine?
Blood in the urine is also called hematuria. Blood that is not visible to the naked eye is also called microsopic, or microhematuria. Blood that can be seen (pink or red urine) is known as gross hematuria. While the amount of blood in the urine between these two is different, the potential risks and evaluation that is needed is the same.
Where does the blood come from?
Hematuria comes from one of the organs that makes or transports urine. This includes the kidney, ureter (tube that transports urine from the kidney to the bladder), bladder, prostate or urethra (tube that transports urine out of the bladder).
How common is hematuria?
It is estimated that up to 20% of the population will have hematuria at some point in their lives. In fact, we all have some degree of hematuria every day-it is estimated that the kidneys filter out about a million"old" red blood cells daily. This normally is not enough blood to show up on testing or to the naked eye.
What are some common causes of blood in the urine?
There are many causes of hematuria. MOST ARE NOT SERIOUS and usually resolve without treatment. These include minor trauma, such as after strenuous exercise, medications that can thin the blood, prostate enlargement, and small kidney stones, to name a few. Other causes, however, may be more serious and include tumors or blockage of the urinary tract, larger stones, kidney inflammation, severe infections or trauma for example.
What are my risks of having a serious problem?
While most people with hematuria do not have a serious underlying cause, there is a list of risk factors that increases the chances of there being a more serious problem. This includes being male, age >50, a smoking history, prior urologic diseases or surgeries, multiple urinary tract infections.
Are there other causes of red urine that are not blood?
Rarely, certain medications (Pyridium) or foods (beets) can cause discoloration of the urine, making it appear to have blood in it. Testing can easily distinguish these "false" causes of hematuria.
How do I know if I have microhematuria?
Microhematuria is found by dipstick or microscopic analysis at the doctor's office. Dipstick testing, the most common office test, has very few false negatives, and thus a clean dipstick test very reliably means there is no significant hematuria. There may be false positives, however, that could be due to contamination ( ie menstrual blood, certain bacteria) and should be ideally confirmed by microscopic analysis of the urine. While not always practical to obtain, the "gold standard" definition of microhematuria is greater than or equal to 3 rbc's/hpf, in at least 2 of 3 specimens examined within an hour of collection.
What evaluation is done for blood in the urine?
Referral to a specialist is mandatory for a complete evaluation. A physical exam, with attention to the blood pressure (the kidneys have a role in this regulation) and the urinary tract is necessary. Sometimes, a urine culture is done to confirm infection. Urine cytology, a test where cancer cells are looked at by expert pathologists, may also be ordered. Often, radiographic test of the kidneys are also done, such as ultrasound, IVP (intravenous pyelogram) or CT scan. A urologist (surgeon who specializes in certain diseases of the urinary tract) may perform an office cystoscopy, using a slender telescope to look at the urethra and bladder.
Who needs to be screened for hematuria?
Currently, there are no medical organizations that recommend routine screening for hematuria, but obviously anyone who has discolored urine or is having possible urinary tract symptoms should be screened with a urine test.
What are the treatments for hematuria?
For gross hematuria, initially, the best recommendation is to increase fluid intake, decrease use of aspirin-like products, and make an appointment with your doctor as soon as possible. Ultimately, for micro or gross hematuria, the treatments vary depending on the underlying cause. As mentioned, usually there is no significant treatment required, other than periodic testing, if no serious underlying cause has been found.
|
