Causes for Hematuria

Hematuria refers to the presence of blood in the urine.   Two types of blood can exist in the urine, visible or invisible blood.  Blood which can be seen in the urine is referred to as gross hematuria, while blood which can only be seen with a microscope is called microscopic hematuria. In hematuria, one or various parts of your urinary tract, which includes the kidneys, urethra and bladder, allow blood cells to leak into urine. While this symptom is not necessarily something to worry about, in some cases it does point to more serious conditions. Hematuria can have symptoms like pain, blood clots, red tinged urine, or you could be asymptomatic. Because the causes of hematuria vary so greatly, paying close attention to symptoms if they arise is key. 

What causes hematuria?

Hematuria can be caused by strenuous exercise, sexual activity, injury or trauma, or infection.  The following is more in depth look at some of the typical causes of hematuria:

• Urinary tract infections: can occur when bacteria enter your body through the urethra and begin to multiply in your bladder
• Kidney infections: can occur when bacteria enter your kidneys from your bloodstream or move up from your ureters
• A bladder or kidney stone: The minerals in concentrated urine sometimes leech out, forming crystals on the walls of your kidneys or bladder. Over time, the crystals can become small, hard stones which are what are referred to as bladder or kidney stones.
• Enlarged prostate: An enlarged prostate can compress the urethra, partially blocking urine flow.  Difficulty urinating, an urgency, and either gross or microscopic blood in the urine can be an indication of this.
• Kidney disease: Microscopic urinary bleeding is a common symptom of inflammation of the kidneys' filtering system. This may be caused by a broader disease like diabetes, or occur on its own.
• Cancer: Visible urinary bleeding may be a sign of advanced kidney, bladder or prostate cancer. Unfortunately, this symptom may not appear in the early stages of the disease to prompt earlier treatment.
• Inherited disorders: Disorders like sickle cell anemia, or Alport syndrome can cause blood in the urine.  The former is a hereditary defect of hemoglobin in red blood cells, while the latter affects the filtering membranes in the glomeruli of the kidneys.
• Kidney injury: An injury to your kidneys from an accident or contact sports can cause blood in your urine that you can see.
• Medications: Common drugs that can cause visible urinary blood include aspirin, penicillin, and the blood thinner heparin.
• Strenuous exercise: Runners are most often affected, although almost any athlete can develop visible urinary bleeding after an intense workout.

Diagnosis and treatment of hematuria:

Aside from seeing blood in the urine, both microscopic and gross hematuria can be diagnosed through urinalysis.  A urinalysis tests a urine sample for red blood cells to make an initial diagnosis of hematuria. The next step is to diagnose the cause of the hematuria so that a treatment plan can be determined.

The treatment of hematuria is accomplished by treating its underlying cause. For example, if hematuria is caused by a UTI it is treated with antibiotics.  If hematuria is caused by an enlarged prostate, prescription medication can be used to shrink the prostate.  Moreover if bladder or kidney stones are the cause of the hematuria, shock wave therapy might be used to break to break up the stones.  If no serious condition is causing hematuria, it is likely that no treatment is needed.