Hematuria is characterized by blood in the urine. Though the cause may be harmless, there is a possibility of a serious underlying issue Visible blood in the urine is called gross hematuria. Urinary blood only visible under a microscope is microscopic hematuria.
Symptoms of Hematuria
Patients with gross hematuria have pink, red, or cola-colored urine because of the red blood cells. It doesn’t take much blood to produce these colors. Bleeding isn’t painful, but passing blood clots can be. Patients may not experience any other symptoms.
Causes of Hematuria
Hematuria occurs when kidneys or other parts of the urinary tract allow blood cells to pass into urine. Causes of this include:
Urinary tract infection: If bacteria enter the body through the urethra, they may multiply in the bladder and cause pain and burning with urination, a persistent urge to urinate, and foul-smelling urine.
Kidney infection: When bacteria from the bloodstream enters the kidneys or moves from the ureters to the kidneys, patients may experience symptoms that may indicate a bladder infection, but are actually a kidney infection.
Bladder or kidney stones: Minerals in concentrated urine can form crystals on the walls of kidneys or the bladder, eventually hardening into stones. Patients typically won’t feel any pain unless the stones are causing a blockage or being passed. In these cases, stones can cause gross and microscopic bleeding.
Enlarged prostate gland: The prostate can get bigger as men approach middle age. An enlarged prostate can compress the urethra, partially blocking urine flow and causing a range of symptoms, such as an urgent or persistent need to urinate, difficulty urinating, and visible or microscopic blood in the urine. An infected prostate (prostatitis) can also cause similar symptoms.
Kidney disease: An inflamed filtering system in the kidney may be part of a chronic condition, such as diabetes, or blood vessel diseases, viral or strep infections, and immune conditions like IgA nephropathy.
Cancer: Patients with advanced kidney, bladder, or prostate cancer may have visible urinary bleeding.
Inherited disorders: Patients with sickle cell anemia, a hereditary defect of hemoglobin in red blood cells, may have visible and microscopic hematuria. Alport syndrome can also affect filtering membranes and cause hematuria.
Kidney injury: An injury to the kidneys during sports or from an accident can cause visible blood in the urine.
Strenuous exercise: Strenuous exercise from sustained aerobic exercise and running can lead to visible urinary bleeding. Other linked causes include dehydration, trauma to the bladder, or the breakdown of red blood cells.
Risk Factors of Hematuria
The risk of hematuria is higher among:
- Men older than 50 due to an enlarged prostate
- Children with a recent viral or bacterial infection causing inflammation
- Patients with a family history of kidney disease or kidney stones
- Patients taking aspirin, antibiotics, and non-steroidal anti-inflammatory pain relievers
- Long-distance runners
- Anyone engaging in strenuous exercise
Treatment for hematuria will depend on the cause, but may involve taking antibiotics, medication to shrink a prostate, or shockwave therapy to break up kidney or bladder stones.
