What is Hematuria?

stetoscopeHematuria refers to the presence of blood in the urine. There are generally two types of hematuria: gross hematuria (where the blood is obvious to the patient) and microscopic hematuria (or microhematuria, where the blood is not noticed by the patient, but rather detected on a urine test – urinalysis). Dr. Kamyar Ebrahimi, a fellowship trained urologist practicing in Glendale CA explains that “gross hematuria is the type of urinary bleeding that the patient sees and complains about to the physician.” On the other hand, microscopic hematuria (microhematuria) is the type of bleeding that the physician alerts the patient about, and is not seen by the patient.

What causes hematuria?

The causes of hematuria are a few. Blood in urine can be due to any problem along the urinary tract. In other words, anywhere that comes in contact with urine in the body, can be the source of the blood in the urine. So, any problem that arises from the kidney, ureters, bladder, prostate (in men), urethra can be the source of the blood in urine. Urinary tract infections (UTI), cancer from the kidney, cancer of the ureters (or the lining of the ureters called urothelium), bladder cancer, bladder stone, cancer of urethra (the tube that carries the urine out of the bladder and to the outside) can all be causes for hematuria. Other causes include kidney stones, trauma to the kidneys (as a result of a punch, accident or even due to rigorous running), certain medical renal diseases, and manipulation of the urinary tract due to surgery.

How is hematuria diagnosed and treated?

Diagnosis is made based on patient complaint (gross hematuria) or based on urinalysis (microhematuria). The treatment centers on figuring out where the bleeding is emanating from, and treating the underlying cause. The work up includes 2 or 3 urine cytologies, cystoscopy (looking into the bladder with a special camera to rule out any lesions as the cause) and imaging of the urinary tract which currently is in the form of CT urogram. Please read about treatment of kidney stones, bladder stones, and bladder cancer for more details by clicking on the respective links.

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