The presence of blood in a patient's urine is referred to as hematuria. This can be either “macroscopic,” which the patient can see, or “microscopic,” which can only be detected using urine test sticks or when a urine sample is sent for analysis.
The presence of blood in the urine may indicate an underlying problem and should always be investigated.
7 common conditions causing hematuria in men
- Vigorous exercise, such as long-distance running
- Vigorous sexual activity
- Urinary stones
- Trauma
- Urinary tract infection (UTI)
- Certain medications, including aspirin and other pain relievers, blood thinners, and antibiotics
- Idiopathic: This is the term for an unknown cause. Despite numerous investigations, the cause of hematuria is frequently unknown.
More serious causes of hematuria in men
- Kidney or bladder stones
- Cancer of the kidney or bladder
- Glomerulonephritis (an autoimmune condition where kidneys are gradually damaged)
Causes in men aged 50 years or older
- Urinary stone disease, including stones in the kidney, ureter, or bladder
- Inflammation of the prostate, benign prostatic hyperplasia (enlargement)
- Cancer of the prostate
- Polycystic kidney disease is a disorder characterized by multiple benign cysts in the kidney
- Blood clotting disorders, such as hemophilia or sickle cell disease
Seeing blood in the urine can be frightening for anyone, especially for the elderly. It may appear to be innocuous at first glance, but it has the potential to aggravate in the later stages. Furthermore, it may be an indication of a larger health problem.
People who have blood in their urine should always see a doctor. Depending on the severity of the symptoms, a referral to a specialist, such as a urologist, may be required.
In addition to blood that may or may not be visible in the urine, other potential signs of infection include:
- Unexplained weight loss
- Burning sensation when urinating
- Frequent or urgent urination
- Fever, nausea, vomiting, shaking chills, or pain in the abdomen, side, or back
- Inability to urinate
- Passing blood clots through the urine
- Pain during sex or heavy menstrual bleeding
- Dribbling urine, excessive nighttime urination, or difficulty starting to urinate
Although these symptoms could be caused by another health issue, a person should see a doctor find out the cause and treatment options.
How do doctors diagnose the underlying cause of hematuria?
Doctors take a medical history and ask about possible causes of hematuria to determine why blood appears in the urine.
A visible and microscopic examination of a urine sample may reveal the source. They may order tests to check for kidney, prostate, and bladder disease, as well as other conditions.
If the doctor suspects that there are other physical abnormalities causing blood to appear in the urine, they may order additional tests, such as:
- Urinalysis: Urine is examined for various cells and chemicals, germs, and proteins.
- Blood tests: Blood is checked for abnormalities in blood or hormones, as well as autoimmune antibodies.
- Imaging tests: A computed tomography, an ultrasound, or magnetic resonance imaging (MRI) scans are examples of these. These scans produce images of the urinary tract to detect tumors, stones, or other abnormalities in the bladder, kidneys, and urinary vessels.
- Cystoscopy: To check for any problems, the doctor inserts a small, lighted tube with a camera through the urethra. A small sample of tissue (a biopsy) may be taken to look for any abnormal cells.
- Intravenous pyelogram (IVP): Before taking an X-ray, which can reveal structural issues with the urinary tract, dye is administered intravenously.
- Kidney (renal) biopsy: If a doctor suspects kidney disease, they may order a kidney biopsy for examination under a microscope.
If the doctor discovers an underlying condition causing the hematuria that condition may be treated.
Often, a person does not require treatment for blood in the urine. If no serious conditions are found, the doctor will most likely retest the urine to see if the blood has resolved or remained unchanged.
The doctor may recommend a follow-up in three to six months to ensure that the hematuria has not returned.
SLIDESHOW
Urinary Incontinence in Women: Types, Causes, and Treatments for Bladder Control See SlideshowWhat are the treatment options for hematuria?
There is no standard treatment for blood in urine since it is a symptom and not a disease. So, to manage the problem, physicians start by evaluating it. Management of hematuria depends on the underlying cause.
The most common treatment options include:
- Wait and watch
- Lifestyle modifications
- Medications
- Surgery
- Chemotherapy
- Radiotherapy
Follow-up testing is often done after treatment to make sure the urine is free of red blood cells.
If blood shows up in the urine repeatedly but there are no other symptoms, urine testing, and physical exams may be done every few months for a year or more as a precautionary measure.
Several measures can be taken to decrease the risk of urinary conditions, such as:
- Drink plenty of fluids: A daily intake of 10 to 12 glasses of water aids in the removal of bacteria and other toxins during urination.
- Urinate when needed: It is best not to put off the urge to urinate because holding the urine for too long will cause bacteria to pool, leading to infections.
- Urinate after sexual activity: Emptying the bladder immediately after intercourse flushes bacteria from the urethra, lowering the risk of infection.
- Maintain hygiene of the genital area: After urinating or defecating, clean the area from front to back to prevent bacteria from reentering the urethra.
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National Institutes of Health. Hematuria (Blood in the Urine). https://www.niddk.nih.gov/health-information/urologic-diseases/hematuria-blood-urine
Urology Care Foundation. Is Blood in your Urine a Reason to be Concerned? https://www.urologyhealth.org/healthy-living/urologyhealth-extra/magazine-archives/winter-2016/is-blood-in-your-urine-a-reason-to-be-concerned
O'Leary MP. Patient education: Blood in the urine (hematuria) in adults (Beyond the Basics). UpToDate. https://www.uptodate.com/contents/blood-in-the-urine-hematuria-in-adults-beyond-the-basics
Yale Medicine. Blood in the Urine (Hematuria). https://www.yalemedicine.org/conditions/blood-in-the-urine
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