Hematuria

Hematuria is the passage of blood in the urine. It can be gross hematuria (when visible to the naked eye) or microscopic hematuria (when visible under only the microscope).

Causes of Hematuria

Hematuria can be caused by one or more of the following:

• Infections of the urinary tract (UTI).
• Stones in the kidney or urinary tract.
• Benign enlargement of prostate in men.
• Tumors anywhere in the urinary tract.
• Ingestion of medicines like quinine and phenytoin.
• Injuries to urinary tract.
• Prior radiation (radiation cystitis).

How can urine be red without blood in it?
Causes other than blood may make the urine red or pink, a situation called pseudo (false) hematuria. This can be caused by consumption of beets, berries, rhubarb, and colors used in food processing.

Examining and Testing a Patient with Hematuria

The treating physician may suggest one or more of the following investigations in a patient with hematuria, to identify the cause:

• Urine analysis.
• Kidney function tests like blood urea nitrogen (BUN) and serum creatinine.
• Urine culture and sensitivity, if infection is suspected, to identify the organism responsible for infection, and to find a suitable drug.
• Ultrasound of the abdomen, CT scan, or intravenous pyelography (IVP) to look for stones, injury or tumors.
• MRI (Magnetic resonance Imaging) for patients who are allergic to contrast or who have impaired kidney function.
• Cystoscopy -- the bladder is visualized with the help of a flexible fiberoptic, pencil-thin telescope for presence of tumors or local trauma, etc.

Urine Samples for Testing

Menstruating women almost always have presence of blood in the urine. Women should get their urine tested when the menses are over. For both men and women, the urine should always be collected mid-stream.

Special Populations at Risk of Hematuria

Smokers or former smokers, and people working in the dye and chemical industries are at an increased risk of developing bladder cancer and, thus, hematuria. So they must consult their physicians at the first sight of blood in the urine.

Treatment of Hematuria

Treatment depends upon the cause. See other links on these pages for diseases and conditions that may lead to hematuria.