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Blood in Urine: Explained By Leading Urologist

blood in urine in a testing tube
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What does blood in the urine indicate?

In medical terms, the condition where you get blood in your urine is called Hematuria. There can be several different causes of hematuria or blood in the urine. It can range from rare blood disorders to cancer or kidney disorders. But don’t be alarmed, sometimes the blood is visible and other times it might be present in such small quantities that it’s not even seen by the naked eye. Mainly hematuria is of two types:

  • Gross hematuria: when your urine looks pinkish or more reddish or has spots of blood.
  • Microscopic hematuria: when the blood is not visible and only lab tests will confirm its presence.

But no matter what the reason or amount, any signs of blood in urine is a sign of a serious health problem, which is why ignoring hematuria is never a good idea. This might just be a symptom of a fatal disease like prostate cancer or kidney failure, hence it is important that it is promptly treated.

What causes blood in urine?

While there are multiple causes, in some cases, the blood may be coming from a different source. So first one must confirm the source of the blood, this is because in the following cases it may show up when you urinate:

  • Blood coming from the vagina in women
  • Blood coming from male ejaculation, and
  • Blood due to bowel movement in men or women.

When it is none of the above and the blood is in your urine, then these may be the possible causes:

  • Infection: This is the most common cause as it may be due to an infection in the urinary tract, bladder or kidneys. When the bacteria move up the urethra you get an infection, because the urethra is the tube through which your urine passes. Sometimes it also spreads to the bladder or kidneys, leading to frequent urination and pain during urination.
  • Stones: The next biggest cause is stones in your bladder or kidneys. Stones are mainly crystals that are formed from the minerals in our urine and mostly develop where the urine is stored or collected in our body. When these stones are large in size, they can cause blockage and lead to blood in urine with pain.
  • Enlarged prostate: Men, especially old or middle-aged, experience blood in urine due to an enlarged prostate gland located near the urethra. An enlarged prostate compresses your urethra preventing your bladder from emptying itself completely. This leads to UTIs with hematuria.
  • Kidney disease: An inflamed kidney can also cause hematuria. But the cause of the inflammation can also be diabetes.
  • Strep infection: Children between the ages of 6-10 years may get blood in urine from an untreated strep infection. But a course of antibiotics can help with it.
  • Cancer: The growth of cancer cells around the urinary area might lead to blood in the urine. This might be a symptom that if detected early can be treated promptly.

Apart from diseases, blood in urine can be due to blunt trauma to the prostate or Kidney area.

How is blood in urine diagnosed?

It is advisable to consult a urologist for the blood in the urine. They will assess the amount of blood you find during urination, your frequency of urination, the pain you feel and the medications for any other existing comorbidities you’re currently on.

After that, you will have a physical examination and a urine sample will be collected for testing and urine culture. The analysis will confirm the presence of blood and detect the cause of the infection. The doctor will also suggest blood work in case there is any symptom that might indicate cancer. If the CA 125 blood test suggests cancer, an imaging test like a PET CT scan will be done to isolate cancer.

Apart from this, your doctor might suggest a cystoscopy, where a small tube is sent up the urethra with a camera to examine the insides of your bladder to isolate the cause of the blood in your urine.

What are the treatments for blood in urine?

There is no one way to treat blood in the urine. Sometimes athletes who undergo rigorous aerobic training can also end up with slight bleeding in their urine. So the best way to treat the problem is by treating the underlying disease that caused it.

If the underlying disease stays untreated, then the body might develop complications associated with hematuria. If it is a symptom of cancer, ignoring it will lead to the formation of new tumours and if it is a symptom of a UTI then it might lead to kidney failure. Basically, it will reach a point of no return. Hence prompt diagnosis is the best way forward.

How to prevent hematuria?

Preventing blood in urine will require preventing the underlying causes. Hence each situation will need to be dealt with accordingly.

  • Drink plenty of fluids and stay hydrated regularly.
  • Practise good urinary hygiene to prevent UTIs.
  • Always wash your privates after intercourse to prevent STIs.
  • Avoid excess salt in addition to staying hydrated and having a diuretic-rich diet to prevent the formation of stones.
  • Refrain from smoking including second-hand smoke to avoid chances of cancer.
  • If you are a sprinter and spot blood in your urine after a workout, immediately seek medical assistance.

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.

To summarise, it is never a good sign to spot blood in the urine. So if this is ever a problem you find yourself in, reach out to our team of award-winning urologists and get prompt treatment before conditions worsen. Book an appointment with leading urologist Dr Shalabh Agarwal at the CK Birla Hospital, today.

FAQ:

Can kidney cysts cause blood in urine?

A polycystic kidney is a congenital disorder where one has a tendency of developing multiple cysts in the kidneys. In case any of these cysts burst, one will find blood in the urine. Over time unless properly managed, polycystic kidneys lead to kidney failure or cancer. So it is better to get diagnosed early on and live a better life.

Should I be worried if my urine is pink?

Yes. This means that you are undergoing gross hematuria. You should immediately seek help from an experienced urologist who will diagnose the cause of the blood. In case you experience painful and frequent urination or pain in the pelvic region with pink urine it is a clear sign of a major problem in your kidneys.

What is the normal range for blood in urine?

When we pass our first urine of the day or we don’t urinate for long hours our urine resembles a reddish-hay colour. This is because urine also contains blood which is not visible to the eye. The normal range of blood in this situation is 4 RBCs under the microscope. Anything more is a cause for concern.

Can anxiety cause bloody urine?

Anxiety and urination are well-linked. We always urinate more before any major event where we are stressed or anxious. Similarly, bloody urine and anxiety can also be linked to each other. When we are anxious, the mucosal defences of our body are lowered which might lead to bloody urine.

Does blood in urine come and go?

Yes. It may come and go. However, it is always safe to consult a specialist for this. Especially if you are nauseous, feverish and have pain in the lower back or abdomen. Seek emergency support if you start seeing blood clots in your urine.

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