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Thread: Blood in urine (hematuria)

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    Blood in urine (hematuria)

    Definition

    Seeing blood in your urine can cause more than a little anxiety. Yet blood in urine — known medically as hematuria — isn't always a matter for concern. Strenuous exercise can cause blood in urine, for instance. So can a number of common drugs, including aspirin. But urinary bleeding can also indicate a serious disorder.

    There are two types of blood in urine. Blood that you can see is called gross hematuria. Urinary blood that's visible only under a microscope is known as microscopic hematuria and is found when your doctor tests your urine for another condition. Either way, it's important to determine the reason for the bleeding.

    Treatment depends on the underlying cause. Blood in urine caused by exercise usually goes away on its own in a day or two, but other problems often require medical care.
    Symptoms

    The only visible sign of hematuria is pink, red or cola-colored urine — the result of the presence of red blood cells. It takes very little blood to produce red urine, and the bleeding usually isn't painful. Bloody urine often occurs without other signs or symptoms.

    In many cases, you can have blood in your urine that's only visible under a microscope (microscopic hematuria).
    Causes

    The urinary tract is made up of your bladder, your two kidneys and ureters, and the urethra. The kidneys remove waste and excess fluid from your blood and convert it to urine. The urine then flows through two hollow tubes (ureters) — one from each kidney — to your bladder, where urine is stored until it passes out of your body through the urethra.

    In hematuria, your kidneys — or other parts of your urinary tract — allow blood cells to leak into urine.
    A number of problems can cause this leakage, including:

    •Urinary tract infections. Urinary tract infections are particularly common in women, though men also get them. They occur when bacteria enter your body through the urethra and begin to multiply in your bladder. The infections sometimes, though not always, develop after sexual activity. Symptoms can include a persistent urge to urinate, pain and burning with urination, and extremely strong-smelling urine. For some people, especially older adults, the only sign of illness may be microscopic blood. About 30 percent of people with a urinary tract infection have visible bleeding.

    •Other urinary tract infections. Kidney infections (pyelonephritis) can occur when bacteria enter your kidneys from your bloodstream or move from up from your ureters to your kidney(s). Signs and symptoms are often similar to bladder infections, though kidney infections are more likely to cause fever and flank pain.

    •A bladder or kidney stone. The minerals in concentrated urine sometimes precipitate out, forming crystals on the walls of your kidneys or bladder. Over time, the crystals can turn into small, hard stones. The stones are generally painless, and you probably won't know you have them unless they cause a blockage or are being passed. Then, there's no mistaking the symptoms — kidney stones can cause excruciating pain. They can also cause both gross and microscopic bleeding.

    •Enlarged prostate. This is one of the leading causes of visible urinary blood in men older than 50. The prostate gland — located just below the bladder and surrounding the top part of the urethra — often begins growing as men approach middle age. When the gland enlarges, it compresses the urethra, partially blocking urine flow. Symptoms of an enlarged prostate (benign prostatic hypertrophy or BPH) include difficulty urinating, an urgent or persistent need to urinate, and either gross or microscopic bleeding. Infection of the prostate (prostatitis) can cause the same signs and symptoms.

    •Kidney disease. Microscopic urinary bleeding is a common symptom of glomerulonephritis, which causes inflammation of the kidneys' filtering system. Glomerulonephritis may be part of a systemic disease such as diabetes, or it can occur on its own. It can be triggered by viral or strep infections, blood vessel diseases (vasculitis), and immune problems such as IgA nephropathy, which affects the small capillaries that filter blood in the kidneys (glomeruli).

    •Cancer. Visible urinary bleeding is often the first sign of advanced kidney, bladder or prostate cancer. Unfortunately, you may not have signs or symptoms in the early stages, when these cancers are more treatable.

    •Inherited disorders. Sickle cell anemia — a chronic shortage of red blood cells — can be the cause of blood in urine, both gross and microscopic hematuria. So can Alport syndrome, which affects the filtering membranes in the glomeruli of the kidneys.

    •Kidney injury. A blow or other injury to your kidneys from an accident or contact sports can cause blood in your urine that you can see.

    •Medications. Common drugs that can cause visible urinary blood include aspirin, penicillin, the blood thinners warfarin and heparin, and the anti-cancer drug cyclophosphamide (Cytoxan).

    •Strenuous exercise. It's not quite clear why exercise causes gross hematuria. It may be trauma to the bladder, dehydration or the breakdown of red blood cells that occurs with sustained aerobic exercise. Runners are most often affected, although almost any athlete can develop visible urinary bleeding after an intense workout.
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    Last edited by trimurtulu; 01-02-2009 at 03:56 PM.

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