Hematuria (Blood in the Urine)

Dr. Virendra is a senior consultant urologist, andrologist, and transplant surgeon at Chandigarh healthcare, sector 16, Mohali and Apollo hospital sector 8c, Chandigarh.  In this video, he will talk and educate us about a urology-related problem called hematuria

What is hematuria?

Hematuria is blood in the urine. This issue i.e., blood in the urine, should not be ignored because this can be an underlying symptom for a more significant and severe problem. Hematuria (a symptom) can sometimes cause pain during urination. But this can also happen without the pain. Not only this, but the person suffering from hematuria can also experience blood clots in his urine. 

How many types of hematuria are there? 

Hematuria can be of two types.

  1. Microscopic hematuria 
  2. Macroscopic hematuria

Macroscopic hematuria

This is when the blood in the urine is visible to the naked eye. The blood can be seen passing with the pee at the start or the end while urinating. It does not cause a lot of blood loss. 

Microscopic hematuria

This type of hematuria is not visible to the naked eye but can only be detected by a urine test. 

What are the two main reasons for hematuria? 

There are generally two reasons for this: 

  • Surgical reasons
  • Medical reasons

When the kidneys’ filters grow in size, the blood easily passes through it, which can cause blood in the urine, also called hematuria. This is caused by Nephrotic syndrome, Nephritis, Vasculitis syndrome, or Nephropathy. It can even be caused due to running or viral infections. 

What causes hematuria? 

Majorly there are five common causes seen for hematuria

  • Infection 
  • Stones 
  • Tumor 
  • Trauma 
  • Drug 

Infection 

Hematuria can be seen in any age group, from children to old-aged people. It can be a kidney infection, ureter, or even prostate infection that causes this disease. It can be bacterial hematuria caused due to infection. It can also be viral hematuria, or it can be tuberculosis. A few more infections can also cause hematuria. 

 Stones

Hematuria stones are found in the kidney, bladder, or ureter. 

Tumor

There can be cancer cells that can cause kidney, bladder, ureter, or prostate cancer. 

Trauma 

Drugs 

Drugs or medicines that we take for the heart. Any Anticoagulants drug can also cause hematuria. Besides these, exercising and radiation can also cause this disease. It can also happen as a side effect of any anti-cancer drug. An injury can also be the reason. Blood in the urine is a condition that should not be taken lightly. Sometimes people see blood in their urine. They think it is because of the heat. Drink a lot of water, and it goes away for a few days. But after a few weeks or months or even years, it can come back. So you keep ignoring the disease inside, and it keeps growing. This is why hematuria is a symptom that should not be overlooked. If you experience blood, burning, and painful urination, we can conclude that it may be because of infections of stones.  Whereas the painless hematuria should not be ignored as it may be because of cancer. 

Treatment for Hematuria

For treating this, it is necessary to diagnose it and find out the cause of this disease. A urine test, an ultrasound, and a simple X-ray are required to diagnose hematuria.

Ultrasound

With the help of an ultrasound, we can pinpoint kidney, ureter, or bladder problems. 

Urine test 

With the help of the urine test, we can find out if puss cells are in the urine. In addition, RBCs, proteins, or casts in the urine can be detected. This also helps us know if it is a medical cause or a surgical cause. Sometimes we do not see accurate results in ultrasound and therefore cannot detect the perfect reason for this. Suppose if the person smokes and then the bladder is the organ that can help us detect that. If it is painless, then telescopic cystoscopy can detect and check the ureter and the bladder. And if a tumor is found, then further, a CT scan or MRI is suggested. The treatment depends on the cause of hematuria. 

If it is an infection, then it is treated by antibiotics. If it is a stone, then it may pass out on its own by receiving medical therapy. But if the stone is big, then it should be removed surgically. First, endoscopic surgery is done to remove the stone. If it is cancer, then it is diagnosed further in detail and then treated accordingly. Finally, it is to be surgically removed. If the diagnosis is complete and no cause is detected. Then hematuria is blamed on the prostate. And medication for prostate is started for the patient. And if this is because of prostate cancer, then it is surgically treated and removed. 

Bottom line

Hematuria is a symptom that should not be ignored at any cost. If it hurts or no, one should consult a specialist. And it should be diagnosed and treated in time, as it can pose a more significant threat if it goes unnoticed. 

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