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Diagnosis of Hematuria
Your doctor will ask about your symptoms
and carry out a physical examination to help determine the cause of the blood
in your urine. For men, this may include a rectal examination and women may
have a vaginal examination.
To find a cause for urinary bleeding, the
following tests and exams play a key role:
Physical exam, which
includes a discussion of your medical history.
Urine tests. Even if your
bleeding was first discovered through urine testing (urinalysis), you're likely
to have another test to see if your urine still contains red blood cells.
Urinalysis can also check for urinary tract infection or the presence of
minerals that cause kidney stones.
Imaging tests. Often, an
imaging test is required to find the cause of hematuria. Your doctor might
recommend a computerized tomography (CT) scan, which uses radiation and a
powerful computer to create cross-sectional images of the inside of the body;
magnetic resonance imaging (MRI), which uses a magnetic field and radio waves
instead of X-rays to produce images; or an ultrasound exam. Ultrasound uses a
combination of high-frequency sound waves and computer processing to produce
images of your kidneys and bladder.
Cystoscopy. In this
procedure, your doctor threads a narrow tube fitted with a tiny camera into
your bladder to closely examine both the bladder and urethra for signs of
disease.
Sometimes, the cause of urinary bleeding
may not be found. In that case, your doctor may recommend regular follow-up
tests, especially if you have risk factors for bladder cancer, such as smoking,
exposure to environmental toxins or a history of radiation therapy.
Risk factors for Hematuria
Factors that make this more likely include:
Age. Many men older than 50
have occasional hematuria due to an enlarged prostate gland.
Your sex. More than half of
all women will have a urinary tract infection at least once in their lives,
possibly with some urinary bleeding. Younger men are more likely to have kidney
stones or Alport syndrome, a form of hereditary nephritis that can cause blood
in the urine.
Kidney infection. Kidney
inflammation after a viral or bacterial infection (post-infectious
glomerulonephritis) is one of the leading causes of visible urinary blood in
children.
Family history. You may be
more prone to urinary bleeding if you have a family history of kidney disease
or kidney stones.
Certain medications.
Aspirin, nonsteroidal anti-inflammatory pain relievers and antibiotics such as
penicillin are known to increase the risk of urinary bleeding.
Strenuous exercise.
Long-distance runners are especially prone to exercise-induced urinary
bleeding. In fact, the condition is sometimes called jogger's hematuria. But
anyone who works out strenuously can develop symptoms.
Treatment of Hematuria
Treatments for hematuria vary widely and
depend on the reason for the bleeding. It is important to note that quite often
no cause is found for the hematuria. If the underlying condition isn't serious,
no treatment is necessary.
If there is infection treatment might
include taking antibiotics to clear a urinary tract infection, trying a
prescription medication to shrink an enlarged prostate, or shock wave therapy
to break up bladder or kidney stones.
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Symptoms
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Complications
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Prevention
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Images
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