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What is Hematuria?

Hematuria is the medical term used when referring to the presence of blood in the urine. Some people suffer from microscopic hematuria, where the blood may only be visible under a microscope. However, in several people, the blood can be seen quite easily, with the naked eye, which is known as gross hematuria. In either case, the cause for bleeding should be determined as soon as possible, and immediate medical treatment would be required. While evaluating hematuria (especially gross hematuria), medical experts often try to narrow down the possible causes, by checking the stage in which the bleeding occurs. While there is no definitive classification, gross hematuria can be divided into three types:

• Initial Hematuria: Bleeding that occurs at the start of urination is called Initial hematuria. This could indicate a problem in the urethra (in women) or the prostate (in men).
• Total Hematuria: Bleeding that occurs while urinating is known as total hematuria. Men could experience total hematuria because of an enlarged prostrate. In women, vaginal bleeding during urination could be an indication of an infection in the bladder, ureter or kidneys.
• Terminal Hematuria: This term refers to bleeding after urination in men and women. Blood after urination in women is usually indicative of a bladder infection. Men can also experience terminal hematuria because of prostate diseases.

All the three types of hematuria need to be checked by a doctor, without any delay.

Causes

Hematuria occurs when your kidney or another part of your urinary tract allows blood cells to leak into the urine. There are several different factors that could cause the leakage to occur, some of which include:

• Urinary Tract Infection (UTI): Many women ask their doctors “can urinary tract infection cause vaginal bleeding?” and the answer to that is “Yes, it can.” However, in most instances, a UTI causes microscopic bleeding, which is only detected when you go for a checkup. You may experience some of the other symptoms of UTI, such as burning or pain while urinating, persistent urge to urinate and strong smelling urine.
• Kidney Infections or Diseases: Bacteria can enter your kidneys through the ureters or the bloodstream. In addition to the usual signs of bladder infection, you may also experience flank pain and fever. Glomerulonephritis, a condition affecting the kidneys generally leads to microscopic hematuria
• Stones in Kidney or Bladder: At times, the minerals in concentrated urine precipitate out and form crystals along the walls of your kidney or bladder. Over a period of time, these crystals turn into small, hard stones. In case where the stone causes blockage, you would experience immense pain. This problem can further lead to gross or microscopic hematuria.
• Enlarged Prostate: As men approach their middle age, their prostate gland may grow a bit. As the gland enlarges, it outs pressure on the urethra and blocks the urine flow partially. In addition to urinating difficulties, men may also experience hematuria. Enlarged prostate is one of the most common causes of bleeding after urination in men.
• Cancer: Hematuria is one of the symptoms of advanced cancer in the prostate, bladder or kidney.

Not all causes of hematuria are a cause for concern. Many people experience bleeding after or during urinating because of certain foods (beets, berries, rhubarbs) medicines, engaging in strenuous exercises or an injury. However, you need to consult a doctor and identify the exact of cause of hematuria as soon as possible.

Symptoms

The main symptom of hematuria is pinkish, red or cola-colored urine. The color of the urine changes because of the presence of red blood cells. The bleeding in not usually painful, unless you are passing blood clots.

Treatment

In order to treat hematuria, your doctor will need to address its underlying cause. Your doctor may prescribe antibiotics, prescription medication, shock wave therapy or even surgery depending upon the cause of the problem. If the underlying condition is not serious, your doctor may just advise you to use some home remedies.

References

1. Margulis V, et al. Assessment of hematuria. Medical Clinics of North America. 2011;95:153.
2. Sandhu KS, et al. Gross and microscopic hematuria: Guidelines for obstetricians and gynecologists. Obstetrical and Gynecological Survey. 2009;64:39.
3. Jimbo M. Evaluation and management of hematuria. Primary Care Clinics in Office Practice. 2010;37:461.
4. McDonald MM, et al. Assessment of microscopic hematuria in adults. American Family Physician. 2006;73:1748.