Hematuria

Hematuria is the abnormal presence of blood in the urine. There are two forms of hematuria. When the urine is visibly pink or red, it is “gross hematuria.” When no blood is visible in the urine, but seen under the microscope, it is microscopic hematuria.

Causes of Hematuria
There are many causes of hematuria. The most common causes of significant hematuria are infections, kidney stones, tumors, and trauma. Blood in the urine can come from anywhere along the urinary tract:

  • kidneys
  • ureters (tubes connecting the kidneys to the bladder)
  • bladder
  • prostate (in men)
  • urethra (tube draining the urine out of the body)

Evaluation
1. Urine specimen
2. Urine culture and sensitivity
3. Blood tests
4. IVP (Intravenous Pyelogram)
5. Cystoscopy

Treatment
The proper treatment for hematuria is dependent on the cause. A small amount of blood can turn the urine bright red and hematuria rarely requires a blood transfusion. Severe gross hematuria with clots requires immediate attention and evaluation. Most hematuria can be evaluated on a less than emergency basis. Hematuria from an infection should be treated with antibiotics. Blood in the urine from a stone or tumor should be treated be addressing that problem. In “idiopathic hematuria,” no cause can be determined. This occurs in as many as 20 percent of hematuria patients. These patients should be followed every six to 12 months with a urinalysis and history to see if things change.

Blood in the urine is a warning signal that should not be ignored, and a thorough evaluation is necessary. If the cause is something serious, a physician wants to diagnose it and begin proper treatment.