Approach to Hematuria

 

Hematuria : It is very painful to see blood in Urine. It can be gross and microscopic (seen under microscope) Treatment depends on the cause. Always evaluate the cause of Hematuria Some causes : 1.Urinary tract infections. Symptoms can include a persistent urge to urinate, pain and burning with urination, even there may be no symptoms especially in old people.  2.Kidney infections (pyelonephritis).  Patients can present with UTI symptoms as above and can have fever and flank pain. 3.A bladder or kidney stone.The stones are generally painless, unless stone causes a blockage .The kidney stones, especially, can cause excruciating pain. Bladder or kidney stones can also cause both gross and microscopic bleeding. 4.Enlarged prostate. The prostate gland — which is just below the bladder and surrounding the top part of the urethra — often enlarges as men approach middle age. It may cause urgency frequency or retention (benign prostatic hyperplasia, or BPH) Infection of the prostate (prostatitis) can cause hematuria 5.Kidney disease. Microscopic urinary bleeding is a common symptom of glomerulonephritis. Glomerulonephritis may be part of a systemic disease, such as diabetes, or it can occur on its own. It could be due to (vasculitis), and immune problems such as IgA nephropathy, which affects the small capillaries that filter blood in the kidneys (glomeruli), can trigger glomerulonephritis. 5.Cancer. Visible urinary bleeding may be a sign of advanced kidney, bladder or prostate cancer. 6.Inherited disorders. Sickle cell anemia — a hereditary defect of hemoglobin in red blood cells — causes blood in urine, both visible and microscopic hematuria. So can Alport syndrome, which affects the filtering membranes in the glomeruli of the kidneys. 7.Kidney injury. A blow or other injury to your kidneys from an accident or contact sports can cause visible blood in your urine. 8.Medications. The anti-cancer drug cyclophosphamide and penicillin can cause urinary bleeding. Visible urinary blood sometimes occurs if you take an anticoagulant, such as aspirin and the blood thinner heparin, and you also have a condition that causes your bladder to bleed. 9.Strenuous exercise. Runners are most often affected, although anyone can develop visible urinary bleeding after an intense workout. If you see blood in your urine after exercise, don't assume it's from exercising. See your doctor.