Hematuria (Blood in Urine): Causes, Symptoms and Treatment

Hematuria, commonly known as blood in the urine, is a symptom that can worry many. This condition, although often harmless, can sometimes indicate more serious health issues. In this comprehensive guide, we’ll explore the causes, symptoms and treatment options for hematuria, helping you understand when you should seek professional advice from a urologist.

What is Hematuria?

Hematuria refers to the presence of red blood cells in the urine. It can be microscopic (not visible to the naked eye and only detectable with a microscope) or macroscopic (visible to the naked eye). It is not an independent condition but a symptom of another underlying condition. Understanding this distinction is critical in diagnosing and effectively treating underlying causes.

Causes of Hematuria

Causes of hematuria vary by age and may include:

• Diseases of the urinary system
• Blood disorders, such as sickle cell disease.
• Cardiovascular diseases, such as endocarditis.
• Use of anticoagulant drugs, such as aspirin.
• General diseases, such as diabetes mellitus or hypertension.

It must be emphasized that there is always the possibility of the coexistence of these diseases with some urological condition that causes hematuria.

Characteristics & Diagnosis of Hematuria

Hematuria can be distinguished into:

• Initial, final, or total, depending on when the bloody urine appears during urination.
• Painless or painful, depending on the coexistence of pain.
• Microscopic or macroscopic, depending on the visibility of the blood.

Diagnosis can be aided by Guyon’s Test (Three-Glass Test) as well as other tests.

Causes of Hematuria from the Urinary System

Any condition of the urinary system can cause hematuria. It is important to consider the possibility of malignancy in every case of hematuria.

This would be:

• Inflammatory diseases: Prostatitis (men), Cystitis (women)
• Lithiasis of the urinary tract (i.e. mainly kidney stones which go down through the ureter)
• Tumors of the urinary system (i.e. bladder cancer).

Urinary Tract Tumors & Hematuria

Certain tumors, such as bladder cancer, often present with hematuria. Other tumors, such as prostate cancer, show hematuria less frequently.

Hematuria Management & Treatment

The patient with bloody urine should consult a urologist immediately. Treatment depends on the cause of the hematuria. In cases of significant hematuria, catheterization and bladder lavages may be required.