Having blood in the urine is not a disease, but a symptom indicating an illness. It is known as ‘hematuria’ in medical terms. In rare cases, blood is only visible when the urine sample is seen under the microscope. This condition is known as microscopic hematuria.
Possible reasons for hematuria are listed below:
Urinary Tract Infection - This is an acute condition which occurs due to bacteria entering the body through the urethra and proliferate in the urinary bladder. Usually, the symptoms include dysuria that is burning during urination, pain, constant urge to urinate and strong smell in the urine. In some elder patients, the condition is manifested as microscopic hematuria.
Benign prostatic hypertrophy (enlargement of the prostate)- The prostate gland is a walnut-sized gland present between the penis and the urinary bladder. It secretes a fluid that provides nourishment and protection to the sperm. The prostate often gets enlarged in middle-aged men causing compression of the urethra and blocking the urine flow. This is manifested as difficulty in urination, urinary urgency, and blood in the urine.
Kidney infection (pyelonephritis)- When the microbes proliferate into kidneys from the blood or the ureters, it leads to the kidney infection. A person tends to have a fever with associated flank pain. In some cases, the patient may also notice blood in the urine.
Kidney stones - Sometimes, the minerals in the concentrated urine are accumulated on the walls of the kidney or urinary bladder in the form of crystals. With time, these crystals tend to become hard stones. Usually, these stones do not show any symptoms, but there may be possible bleeding if any blood vessel gets damaged. Other symptoms related to kidney or bladder stones include sharp pain and urinary blockage.
Sickle cell anemia - It is a genetic defect of hemoglobin in the red blood cells. Patients with sickle cell anemia have a distorted shape of red blood cells in the form of a sickle. The condition is characterized by blood in the urine.
Other than this Alport syndrome, which affects the filtering membranes of the glomeruli in the kidneys, is also characterized by hematuria
Kidney and bladder cancer - Blood in the urine is the most prominent sign of kidney and bladder cancer. The most common type of cancer which causes hematuria is Renal Cell Carcinoma.
Medications - Certain anti-cancer drugs such as cyclophosphamide and penicillin can potentially cause urinary bleeding. In some cases, anti-coagulating agents like aspirin and blood thinners like heparin can also cause bleeding in the bladder.
Excessive exercise- In rare cases, arduous exercise can cause hematuria. The cause may involve dehydration to red blood cells leading to breakdown.
Some other causes may involve:
Injury to the urinary tract
Chronic kidney disease
Factors increasing the risk for hematuria
Family history - Genetic is always a prominent cause for any condition. Any family history of kidney related disorder in the family increases the tendency of having blood in the urine.
Age - Patients, especially men older than 50 years of age tend to have hematuria due to enlargement in the prostate glands.
Infection - Any recent infection in the kidney can be a cause of hematuria as the kidney gets inflamed after any viral or bacterial infection.
How is hematuria diagnosed?
A person must visit a doctor as soon as he/she notices any tint of blood in the urine. The diagnosis usually starts with a detailed medical history in which the urologist will ask you about the signs, symptoms, and factors relieving or aggravating them. This will be followed by the following tests:
Urinalysis - The urine samples are sent to the laboratory for analysis.
Urine cytology - This is used along with other tests for microscopic investigations to look out for any abnormal cells in the urine.
Urine culture - This is another type of urine examination to investigate any infection.
Cystoscopy - A device known as cystoscope attached with a camera is used to look inside the urinary bladder and the urethra. Tissues samples can also be procured if needed for the biopsy.
Computed Tomography (CT) scan - A special type of imaging test that is used to detect any stones, tumor or any other abnormality in the kidneys, bladder, and ureters. It takes cross-sectional images of the abdomen and the pelvis.
Intravenous pyelogram - This is another x-ray like imaging test in which a dye is inserted to examine the urinary tract.
Kidney ultrasound - This uses sound waves to create an image of the kidneys.
Renal biopsy - A sample of tissue is extracted from the affected area and send for examination under a microscope. This is specially used in cases where Kidney disease is suspected.
Since hematuria is just a symptom and not a disease in itself, the underlying condition has to be treated. An accurate diagnosis is the most important stem for effective treatment. There are some top urology hospitals in India, well-equipped with equipment that help in making the precise diagnosis for the patients.
Based on the results of urinary investigations, the treatment plan is decided. For example, if there is a urinary infection, antibiotics will be prescribed. Once the infection causing microbes are killed and the infection is treated, hematuria will get resolved by itself.
Other than the aforementioned list of urinary disorders, certain other factors may also contribute to causing blood in the urine. According to the best urologists in India, prevention of the following factors can help in preventing the condition:
Excessive use of pain-relieving medications
Over-exposure to radiations from radiation therapy or imaging tests
Running for long distances
Exposure to certain chemical substances