Hematuria is the presence of blood in the urine. Sometimes the amount of blood in the urine may be large enough to colour the urine red and it is then obvious to the naked eye. Hematuria naked to the visible eye is called gross hematuria.

But often, the urine looks normal, but is accidentally discovered during microscopic testing of urine for other reasons. In such cases, the urine test will show increased red blood cells (RBCs) in the urine. This is called as microscopic hematuria.

What are the causes for hematuria?

Most often the hematuria is transient and not serious. For example, strenuous physical exercise can lead to increased breakdown of muscle leading to blood in urine. Often an underlying problem cannot be found and the problem resolves in a few days.

Other more serious causes are

  • Tumors in the urinary system
  • Kidney disease including stones
  • Urinary tract infections
  • Injury
  • Some prescription medications.

When should you get worried?

You need to consult the urogynecologist/urologist immediately if you experience blood in your urine that lasts more than a day, especially if you have sudden unexpected weight loss, discomfort while passing urine, frequent urination or urgency.

How is underlying cause for hematuria diagnosed?

A thorough history and physical examination is crucial. The accompanying symptoms like painful urination, pain in abdomen and fever can point to the underlying condition. The following tests may be requested:

  • Urine test: A thorough urine test will help determine if infection or kidney disease is responsible. In the presence of kidney disease, urine test may reveal increased proteins.
  • Blood tests to look for kidney disease
  • Intravenous pyelogram (IVP): This test involves taking X-rays of the kidney, ureters and bladder following the injection of a contrast dye into a vein. IVP helps to detect tumours, stones or any other abnormalities of the kidneys and to evaluate the renal blood flow.
  • Renal ultrasound may be useful in certain situations
  • Cystoscopy: It involves the examination of the inside of the bladder and urethra with the help of a lighted telescope inserted through the urethra. Any tumors, obstruction, structural abnormalities or infection of the bladder will be revealed.

What is the treatment for hematuria?

The treatment of hematuria depends on the cause, the extent of the disease, your overall health and medical history. Often no treatment is required and the problem resolves on its own.

Your doctor will discuss the treatment options that are tailored to your needs and the results of the investigations.

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