Hematuria - or blood in the urine - can be a cause of worry, as it is usually an abnormal occurrence. However, there is a possibility that its cause is either benign or an indication of something serious
The presence of blood in the urine may or may not be seen. If you see blood in your urine, you are suffering from gross hematuria, while blood that’s only visible under a microscope is called microscopic hematuria.
A wide range of conditions such as urinary tract infections, kidney stones and kidney diseases could cause blood in the urine. Thus, a concrete diagnosis backed with confirmatory tests is needed to properly treat the condition.
To be able to find the cause of the presence of blood in the urine, the following may be done:
During consultation, the doctor will obtain some pertinent information with regards to the patient’s medical history. The symptoms of the patient as well as medications will be reviewed. Past medical conditions may also need to be discussed.
During physical examination, a palpation on the abdomen and back may be performed to assess for pain and tenderness in the area of the bladder and kidneys. In men, a rectal examination may be done to check for prostate problems such as an enlarged prostate. On the other hand, a pelvic exam may be performed in women to look for the possible source of red blood cells found in the urine.
Urinalysis is usually the first option when looking for traces of blood in the urine. It can be ordered even if you cannot see blood in the urine. Aside from blood in the urine, urinalysis can also check for infections in the urinary tract, as well as the presence of minerals which cause kidney stones.
Women who are currently on their menstrual period may opt to postpone having urinalysis because the blood from the menstrual period can affect the urine sample. This will result to a false-positive test.
If the doctor suspects other conditions that cause hematuria, imaging tests such as MRIs, CT scans and ultrasounds may be recommended. An MRI - or magnetic resonance imaging - uses radio waves and magnetic fields to produce images, while a CT (computerized tomography) scan uses radiation and computers to create cross-sectional images of the organs inside the body. Lastly, ultrasound uses high frequency sound waves to be able to produce images of the bladder and kidneys.
During cytoscopy, the doctor threads a thin tube fitted with a small camera into the bladder to closely assess the bladder and urethra for any signs of a disease.
A kidney biopsy is a procedure which involves obtaining a small sample of tissue from the kidney. The sample will then be sent to the laboratory for examination. A kidney biopsy can help determine if the cause of hematuria is a kidney disease.
These diagnostic procedures are all helpful to determine the cause of hematuria. However, in some cases, the cause of blood in the urine may not be found. In these cases, follow up tests must be conducted on a regular basis, especially if a person has risks of developing bladder cancer.