Hematuria is the presence of blood, specifically red blood cells, in the urine. Whether the blood is visible only under a microscope or to the naked eye, hematuria is a sign that something is causing bleeding in the kidneys, ureters (tubes that carry urine to the bladder), prostate gland, bladder or urethra.WHO IS AFFECTED
Hematuria occurs in up to 10 per cent of the general population. The frequency of bleeding may differ. It can indicate various problems in men and women. Causes of this condition range from on-life threatening infections to the more serious kidney, bladder or prostate cancers.
KINDS OF HEMATURIA
There are two types of hematuria, microscopic and gross or macroscopic. In microscopic hematuria, the amount of blood in the urine is so small that it can only be seen under a microscope. A few experience microscopic hematuria that has no discernible cause (idiopathic hematuria). These people excrete a higher number of red blood cells. In gross hematuria the urine is pink, red, or dark brown and may contain small or large blood clots. The amount of blood does not necessarily indicate the seriousness of the problem. As little as 1 millilitre of blood can turn the urine red. Hematuria can also be caused due to jarring of the bladder while jogging or running long distance. This is known as ‘Joggers hematuria’. Reddish urine that is not caused by bleeding is called pseudohematuria. Excessive consumption of beets, berries, or rhubarb; food colouring, pain medication and certain laxatives can cause this.
Many conditions are associated with hematuria. The most common causes include enlarged prostate, kidney, ureter or bladder stones, kidney disease (Nephritis), prostate infection, trauma (e.g. a blow to the kidneys), tumours or cancer in the urinary system, urinary tract blockages or serious infection like tuberculosis, viral infections and sexually transmitted diseases.Hematuria can also be caused due to rare diseases and genetic disorders.
PINNING THE PROBLEM
Bleeding is classified by when it occurs during urination, which may indicate the location of the problem. If blood appears at the beginning of urination it indicates it is from the urethra or prostate, if it is present throughout urination (total hematuria) it is probably from the bladder, ureter, or kidneys. If blood appears at the end of urination it is indicative of a prostate disease. Family history may reveal inherited predispositions or problems associated with hematuria.When blood is discovered in the urine it is important to consult a urologist or nephrologist. Tests like urine culture, endoscopy, ultrasound scan or CT scan can then be ordered to diagnose the problem.
The writer is the CEO of Dr Ramayya’s Urology, Nephrology Institute and Hospitals