Hematuria Presence of blood in urine
An episode of blood in the urine should always be investigated without delay by a doctor, your Urologist or GP.
Blood in the urine may be visible to the naked eye (macroscopic hematuria) or only be detected in a urine analysis (microscopic hematuria).
What are the main causes?
It is important to note that the amount of blood is not necessarily related to the severity of the situation. A small amount can be a sign of serious illness, especially of malignant tumors. There must, therefore, be a high degree of suspicion.
Blood in the urine may be accompanied by other urinary symptoms, which may help determine the cause.
The most frequent causes of blood in the urine are:
- Benign prostatic hyperplasia
- Blood clotting disorders
- Anticoagulant or antiplatelet medicinal products
- Trauma
- Interstitial cystitis or radic cystitis
- Medical or urological instrumentation
How is it diagnosed?
The evaluation of hematuria should include a complete medical history and urine and blood tests.
Your doctor may order a bladder and renal ultrasound in the first instance to identify or exclude kidney and bladder pathology. CT Urography is one of the tests of choice for the evaluation of urinary tract diseases, but your urologist may also perform a cystoscopy for confirmation.
How is it treated?
The treatment is variable and depends on the cause. You should always consult your Urologist to be properly evaluated and treated.
If the blood is accompanied by blood clots, the treatment will usually be in the context of urgency, with a graft and lavage of the bladder with serum. Hemorrhage, regardless of cause, usually ceases without the need for surgical intervention, and in the most serious cases, a hospital stay may be necessary.
In patients taking antiplatelet agents or anticoagulants, these should be discontinued until a medical indication is obtained.
If the cause is an infection, antibiotic treatment will probably resolve the problem. There may, however, be an underlying disease requiring evaluation and treatment, especially if the infections are recurrent and / or accompanied by other symptoms.
If the cause is a calculation of the urinary tract, it should be broken and eliminated.
If we are in the presence of a bladder tumor, this should be removed surgically. The histological characterization of the tumor will determine the need for subsequent treatment and the level of follow-up, which is usually tight.
In the case of a tumor of the kidney, this should be, if possible, removed surgically.