How common is hematuria?

Hematuria or blood in the urine can have many causes—ranging from infections, kidney disease and even vigorous exercise. Based on thorough history, clinical examination and investigations, healthcare provider like Urologist in Lahore narrow down the cause of hematuria and help find the best treatment options. Read on to know more about hematuria, its symptoms, risks, causes and management options:

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What is hematuria?

Hematuria refers to blood in the urine, which can have many benign causes, as well as more serious underlying disorders. Blood that is visibly present in the urine is referred to as gross hematuria, while microscopic hematuria is found on urine examination. Both gross and microscopic hematuria warrants a complete investigation to determine the exact cause.

What are the symptoms of hematuria?

Hematuriacan present as:

· Pink, red or dark urine

· Passing of blood clots in urine

What are the causes of hematuria?

The causes of hematuria can include:

· Kidney infections: pyelonephritis is when bacteria can enter the kidneys from the bloodstream. The signs and symptoms of kidney infection are similar to cystitis and UTIs. Patients often complain of back pain with high grade fever and hematuria.

· Urinary tract infection (UTIs): these are a common cause of hematuria in adults. UTIs occur when bacteria ascend through the urethra to the bladder, and are more common in women due to the shorter length of urethra.

· Kidney or bladder stones: stones can be painless in general. However, when they cause blockage or become larger in size, they can cause excruciating pain and gross hematuria.

· Kidney disease: like glomerulonephritis can commonly cause bleeding. This can occur on its own, or secondary to a systemic disorder like diabetes.

· Prostate disease: as men approach middle age, they can have enlarged prostate compressing the urethra and blocking the urine flow. If there is subsequent infection of the prostate, there can be hematuria, as well.

· Cancers: gross and persistent hematuria can be sign of advanced tumors of the prostate, bladder or the kidney itself.

· Kidney injury: trauma to the kidneys can result in injury, such as that seen in contact sports or vehicular accident. This can cause visible hematuria.

· Medication: certain drugs like cyclophosphamide (anti-cancer drug) or penicillin can result in gross hematuria. Other drugs responsible for hematuria include antiplatelet medication and pain killers.

· Genetic disorders: such as sickle cell anemia involve a structural defect in the hemoglobin found in red blood cells. This can result in microscopic and gross hematuria.

Who is at risk of developing hematuria?

The risk of hematuria rises in:

· Older men over the age of 50 years

· Men with enlarged prostate

· People with urinary stones

· Patients with family history of kidney disease

· Patients with recent history of bacterial or viral infection (post-infectious glomerulonephritis)

· Patients with hepatitis

· People on certain antiplatelet medication like aspirin, pain relievers and antibiotics

· People with history of vigorous exercise such as long-distance running (jogger’s hematuria)

How is hematuria diagnosed?

Other than urine examination, investigations for diagnosing hematuria include:

· Blood tests: blood picturecan help to narrow down the cause of hematuria. A blood test with hematuria can detect high levels of creatinine, indicating kidney disease, or signs of autoimmune disease such as SLE as well as prostate cancer.

· Cystoscopy: this investigation is performed by a urologist to see inside the bladder of the patient. A tube-like instrument with a camera at the end is inserted into the bladder through the urethra to look for gross abnormalities and take a biopsy if needed. The procedure is performed in the outpatient department and helps to rule out many causes of hematuria.

· Imaging studies: CT scan, ultrasound and MRI of the urinary system helps to create images of the urinary tract to diagnose many causes of hematuria. Obstructions, stones, infections, tumors, traumatic injuries and cysts can be diagnosed with the help of these imaging studies.

· Kidney biopsy: this procedure involves taking a small piece of tissue from the kidneys under light sedation. Thereafter, the tissue is examined under microscope by the pathologist to rule out tumors and diagnose the exact cause of hematuria.