BLOODY URINE (HEMATURIA)
Blood in your urine, or hematuria, can be classified as microscopic or gross.
- Microscopic hematuria is when there is very little blood in the urine and it can only be seen with a microscope.
- Gross hematuria is when there is enough blood in the urine that you can see it with the naked eye. Usually it turns toilet water pale pink or bright red, or you may just see spots of blood in the water after urinating.
You may not see blood in your urine. In some cases, it may only be found when your doctor checks your urine during a routine exam. Your doctor will follow up on this problem to see if it persists and identify the cause. When blood is visible to the naked eye, prompt and thorough evaluation is always needed. In children, hospitalization is often necessary to complete the work up
What causes hematuria?
Several conditions can cause hematuria, most of them not serious. For example, exercise may cause hematuria that goes away in 24 hours. Many people have hematuria without any other related problems. Often no specific cause can be found. But because hematuria may be the result of a tumor or other serious problem, a doctor should be consulted.
How is hematuria diagnosed?
To find the cause of hematuria, or to rule out certain causes, the doctor may order a series of tests, including urinalysis, blood tests, kidney imaging studies, and cystoscopic examination.
- Urinalysis is the examination of urine for various cells and chemicals. In addition to finding RBCs, the doctor may find white blood cells that signal a urinary tract infection or casts, which are groups of cells molded together in the shape of the kidneys' tiny filtering tubes, that signal kidney disease. Excessive protein in the urine also signals kidney disease.
- Blood tests may reveal kidney disease if the blood contains high levels of wastes that the kidneys are supposed to remove.
- Kidney imaging studies include ultrasound, computerized tomography (CT) scan, or intravenous pyelogram (IVP). An IVP is an x ray of the urinary tract. Imaging studies may reveal a tumor, a kidney or bladder stone, an enlarged prostate, or other blockage to the normal flow of urine.
A cystoscope can be used to take pictures of the inside of the bladder. It has a tiny camera at the end of a thin tube, which is inserted through the urethra. A cystoscope may provide a better view of a tumor or bladder stone than can be seen in an IVP.
(Source: National Library of Medicine, 2007)
