Is blood in urine always serious?

The sight of blood in urine is enough to make anyone panic.  Although not always a significant symptom of disease, blood in urine can be an important warning sign of a possible health problem. No matter what age you are, this sighting indicates something is going on making it imperative to contact your doctor right away to rule out any serious conditions.  This is especially true if you are also having the following symptoms along with blood in your urine:

·      Frequent, painful or urgent urination

·      Nausea, vomiting, fever, or pain in your abdomen

Medically, blood in the urine is known as hematuria.  There are two forms of hematuria:

·      Gross Hematuria – This is when you can see blood in the urine.  The urine may look pink, red, or cola-colored due to the presence of red blood cells (RBCs).  Most of the time, other than the change in appearance in urine, most people do not have other symptoms.

·      Microscopic Hematuria – This is when you cannot see blood in the urine but it can be seen when the urine is examined with a microscope.  Most people with microscopic hematuria have no symptoms.

Causes of blood in the urine

When a person has hematuria, the kidneys or other parts of the urinary tract allow blood cells to leak into the urine.  Anyone, including children, can be at risk for blood in the urine.  There can be many reasons for this and it does not automatically mean a serious condition.  Some common causes of hematuria include:

·      Menstruation

·      Vigorous or strenuous exercise

·      Sexual activity

·      Urinary tract infection

·      Kidney infection

·      Kidney or bladder stone

·      Injury

·      Bacterial or viral infection

·      Family history of kidney disease

More serious problems that could be causing blood in your urine might be:

·      Kidney or bladder cancer

·      Polycystic kidney disease

·      Irritation or swelling in the kidney, prostate in men, or another part of the urinary tract

·      Blood clots

·      Sickle cell disease

·      Enlarged prostate

·      Medications – the anti-cancer drug cyclophosphamide (Cytoxan) and penicillin can cause urinary bleeding. 

Diagnosing hematuria

Hematuria is diagnosed with a urine sample called a urinalysis.  The urine sample is collected in a special container at a doctor’s office and usually tested in a lab for analysis.  The lab technician places a strip of chemically treated paper called a dipstick in the urine.  If RBCs are present, patches on the dipstick change color.  When RBCs are noted, then the urine is further examined under a microscope to make the diagnosis of hematuria. 

Depending on the circumstances, the doctor may order further testing such as a complete blood count (CBC), CT scan, an abdominal ultrasound or a procedure called cystoscopy. 

Cystoscopy, also known as cystourethroscopy, is a procedure allowing a doctor to examine the lining of your bladder and urethra in detail.  The purpose is to diagnosis, monitor, and treat conditions affecting the bladder and urethra especially in cases of someone having blood in their urine. 

Done on an outpatient basis, cystoscopy is a 5 to 10 minute procedure using a thin, lighted tube called a cystoscope that is inserted through the urethra into the bladder.  Water or saline will be infused through the cystoscope into the bladder stretching the bladder wall in order for the doctor to get a clear view of the bladder aiding in making an accurate diagnosis.

Treating hematuria

Hematuria is treated by treating its underlying cause.  If the reason for hematuria is not serious, no treatment may be necessary.  If it is caused by a urinary tract infection, it will be treated with antibiotics.  A urinalysis should be repeated within 6 weeks after antibiotic treatment ends to be sure the infection is gone. 

If the cause is more serious such as finding a kidney infection, prostate infection or possible cancer, depending on what is the situation will determine what the next course of action will be.