Urine with blood

In medical terminology, the presence of blood in the urine is defined as hematuria. This is one of the main symptoms of damage to the urinary tract or kidneys. Hematuria always indicates serious problems that need to be diagnosed. What you need to know about the condition, for what reasons does blood appear in the urine and which specialist should I contact?

General characteristics of the state

In the urine of a healthy person, there should be no bloody impurities or their amount should be limited to 1-2 erythrocyte cells. Depending on the amount of blood in the biological fluid, doctors distinguish two conditions – macro- and microhematuria. In the first case, the patient can visually note a change in color or whole blood clots in the urine. In the second, the presence of erythrocytes can only be determined by microscopic examination.

Modern pharmacology has rapid tests that determine the concentration of red blood cells / hemoglobin in the urine. The test is made in the form of a strip that is in contact with biological fluids and changes its shade depending on the result.

Varieties of hematuria

There are three main types of hematuria: initial, final and total. With the initial or initial variety, blood impurities are fixed only in the first (morning) portion of urine. Most often, this indicates a pathological process in the back of the urethra. You can recognize the final or terminal hematuria by blood clots or the scarlet color of the last portion of urine (before going to bed). The symptom may indicate a disease of the bladder or prostate gland. With the total variety, each urination is accompanied by the release of blood. This is possible with diseases of the bladder, ureter and kidneys.

To determine the type of hematuria, you should contact a urologist, take a urine test and wait for the results. The main thing – do not self-medicate. Strictly follow the instructions of the doctor, go through the diagnosis, so as not to aggravate the situation.

Additionally, there is a classification according to the source of blood loss. So hematuria is divided into glomerular and postglomerular. What does it mean? With the glomerular variety, red blood cells pass through the glomerular filter (located in the kidneys) and are deformed. Such an erythrocyte is slightly inferior in volume, differs in shape and size. All these characteristics can be recorded under microscopic examination. Blood cells are devoid of hemoglobin and appear as colorless rings that are difficult to visually distinguish. Damaged cells are called “leached” or “shadows of erythrocytes”. This type of blood loss is typical for diseases of the heart, blood, liver, some oncological or infectious pathologies.

Sometimes glomerular hematuria occurs against the background of the use of drugs that reduce blood clotting.

With the postglomerular variety, there are no morphological changes in blood cells. This indicates that the source of blood loss is located after the glomerular filter. So the red blood cells don’t have to pass through it to get into the urine. A symptom may indicate injury or pathology of the kidneys, urinary tract.

Blood in the urine can be a one-time occurrence. If you notice bloody impurities or an unnatural shade of urine, consult a doctor immediately. It is very important not to ignore the symptom, and not to allow the disease to develop freely in the body.

Possible causes of development

There are about 200 possible causes of hematuria, both physiological and pathological. Most often, the symptom occurs due to injury or disease of the genitourinary system. Among the most dangerous causes are oncological diseases (malignant tumors), which in most cases are accompanied by hematuria.

Common causes of development include:

• stones in the bladder, prostate, or kidneys;
• glomerulonephritis (kidney disease);
• tumor processes in the kidneys, bladder, prostate gland and other internal organs;
• hemophilia (chronic bleeding), increased blood clotting;
• specific genetic changes (familial hematuria);
• nocturnal paroxysmal hemoglobinuria (a rare condition in which hemoglobin passes into the urine);
• admixture of blood clots from the genitals in women (may indicate menstruation or gynecological diseases);
• urogenital schistosomiasis (a tropical disease caused by flukes);
• internal injuries and injuries caused by a urinary catheter.

In a separate category, doctors distinguish false hematuria. It causes redness of the urine, but is not associated with serious internal disorders. Pseudohematuria occurs after eating food, biologically active substances, drugs, which include coloring enzymes. These can be anthocyanins contained in red foods, red food colors (most often added to confectionery), phenolphthalein, porphyrins, and so on.

With false hematuria, no blood cells are found in the urine. The biological fluid temporarily changes its shade until the coloring element is completely removed from the body.

How to recognize and deal with a symptom?

The patient may not always visually recognize hematuria. Sometimes the number of red blood cells is so small that a person simply does not notice the changes. Most often, the condition is aggravated by frequent urination, a sharp jump in body temperature, and aching pains in the abdominal cavity. There are urges to empty the bowels, but going to the toilet does not give results. Hematuria may also be accompanied by fever, loss of appetite, general malaise, and muscle weakness.

Diagnosis of hematuria

Have you noticed blood clots or a change in the color of your urine? Please see a urologist instead. The appointment begins with standard questions about well-being, diet, and the use of certain medications. So the urologist will exclude false hematuria, make a preliminary diagnosis, which will determine the course of the diagnosis.

First of all, the specialist issues directions for testing. Among them – a general analysis of blood and urine, microscopy of urine, urine analysis according to Nechiporenko. The results of the tests will be able to confirm or refute the diagnosis. Additionally, the urologist prescribes diagnostic manipulations in order to find out the cause of the presence of blood in the urine. As a diagnosis, ultrasound, radiopaque angiography, cystoscopy, computed tomography or intravenous urography are used.

Therapy and prevention

Hematuria is a symptom, not an independent disease. The therapeutic course is based on the elimination of the root cause, after which the blood in the urine will also disappear. In most cases, hematuria is caused by infectious or inflammatory processes that are stopped by medication. If the root cause is hidden behind an oncological pathology (regardless of its nature), surgical intervention may be required.

Do not self-medicate and do not delay visiting the doctor. The sooner you start therapy, the more successful its outcome. Enjoy the benefits of modern medicine and be healthy.

Sources of