Hematuria

About Hematuria

Hematuria is a condition in which red blood cells appear in the urine.  Sometimes the presence of blood is microscopic and cannot be seen with the naked eye while at other times, the amount of blood present in the urine is considerable enough to change the color of urine a bright red.  Hematuria is symptomatic of many conditions, from common urinary tract infections to cancer.  The blood in the urine is indicative of a problem within the urinary system, and can originate from the kidneys, ureter, bladder, urethra, or prostate gland.  

The source of the hematuria is either classified as being glomerular or nonglomerular. The glomerulus is part of the kidney and and is instrumental in filtering fluid from the bloodstream during urine production.  Glomurular hematuria is therefore related to the glomerulus, and can be a sign of glomerulonephritis or kidney disease.  An example of this condition is IgA nephropathy, a disorder in which amounts of the IgA protein build up in the kidneys.  This can result in blood loss from the kidneys into the urine,as well as small amounts of protein.  Nonglomerular hematuria refers to cases of blood in the urine not related to the glomerulus, and can be caused by anything from certain medications to urinary tract infections.  However, a most concerning cause of hematuria may be a cancer involving the urinary tract, including bladder cancer, prostate cancer, or kidney cancer.

Microscopic Hematuria

Microscopic hematuria is a type of hematuria that is not visible to the naked eye and requires the use of a microscope.  It's defined by having at least 3 red blood cells per high-power field, and is often asymptomatic.  Sometimes, its cause can be completely benign, such as a bout of vigorous exercise just before urine collection.  In some cases, though, it can be indicative of a much more serious condition.  Since anywhere between 18-68% of cases of Microscopic Hematuria may not have a readily identifiable cause, a full urological workup is recommended to rule out serious conditions such as genitourinary cancers.
 
Gross Hematuria

Unlike microscopic hematuria, Gross hematuria is visible to the naked eye and can cause the urine to take on a reddish or brownish tinge. It too can be indicative of a wide variety of symptoms, so a careful urological checkup is necessary.  The condition may be persistent and recurrent, or can occur just once.    

Causes of Hematuria

Hematuria is a common initial symptom of many urological disorders and conditions.  Therefore, the detection of Hematuria is often used as a tool for early detection of many serious urological conditions and cancers.
  • Urinary tract infection (UTI) - A common cause of hematuria, urinary tract infections are infections that occur at some point along the urinary tract, such as the urethra or bladder.  The condition can intensify greatly when the infection reaches the upper urinary tract, consisting of the ureter and kidney, and can cause serious complications.
  • Kidney stone - Kidney stones may also result in hematuria, regardless of the type, shape, or size of the stone.  Sometimes hematuria can occur even in the absence of a stone, as long as the conditions in the kidney are favorable for stone formation, such as an excess of calcium or cysteine.
  • Bladder stone - Similar with kidney stones, the presence of a bladder stone can lead to hematuria, one of the most common symptoms.
  • Benign Prostatic Hyperplasia (BPH) - Although BPH is benign, it can lead to many pesky symptoms, such as hematuria.  It has been found that almost 20% of hematuria cases may be related to BPH.
  • Prostate cancer - Although not always a symptom, hematuria can sometimes be associated with prostate cancer.  The symptoms for prostate cancer often overlap with those for BPH, so it's important to get regular checkups by a physician.
  • Bladder cancer - As much as 85% of bladder cancer patients exhibit gross hematuria.  Bladder cancer is more prevalent in men than in women, and has a high recurrence rate.
  • Kidney cancer - About 40% of kidney cancer patients display gross hematuria.  Left alone, the results could be disastrous, which is why it's so important for physicians to pinpoint the cause of hematuria as soon as possible. 

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