What is Hematuria?

Hematuria is defined as the presence of red blood cells in the urine. It can be characterized as either “gross” (visible to the naked eye) or “microscopic” (visible only under the microscope). Microscopic hematuria is often an incidental finding often discovered on urine tests as part of a routine medical evaluation.
Hematuria can originate from any site along the urinary tract, including the kidneys, ureters, bladder, prostate and urethra.

What should you do if you find out that there’s blood in your urine?

Visible hematuria is often worrisome and may prompt you to seek medical attention; however, microscopic hematuria can be just as significant. Both types of hematuria are abnormal and should never be ignored. Notify your doctor even if you see blood only once so that you can be evaluated.

What are the common causes of hematuria?

In many people, blood in the urine not a sign of significant disease and no specific cause is found. However, hematuria may be a marker for a serious underlying condition.

Risk factors for significant underlying disease include:

  1. Smoking
  2. Radiation
  3. Overuse of some pain medication
  4. Exposure to certain chemicals.

Common causes of hematuria include:

  1. Idiopathic- no cause found
  2. Stone Disease (kidney, bladder, ureter)
  3. Urinary Tract Infection
  4. Kidney Infection
  5. Enlarged Prostate or BPH
  6. Kidney Disease
  7. Radiation or chemical induced cystitis (Bladder Irritation)
  8. Injury or trauma to the urinary tract
  9. Prostatitis (Prostate Infection)
  10. Exercise hematuria
  11. Tumors (Bladder, kidney, prostate, ureter, or urethra)

How is hematuria diagnosed?

Often hematuria has no symptoms and is detected on a urine dipstick test. If the dipstick test is positive for blood, the amount of blood is often determined by looking at the urine with a microscope. If three or more red blood cells (RBC) are seen per high power field on two of three specimens, further evaluation to determine a cause is recommended.

What additional tests are needed?

Further evaluation may include:

  1. History and physical examination.
  2. Urinary cytology to look for abnormal cells in the urine.
  3. Computerized tomography (CT) scans and other special imaging to evaluate for urinary tumors and urinary stones.
  4. Cystoscopy to evaluate the bladder. Usually performed in the office under local anesthesia, the urologist inserts an instrument called a cystoscope through the urethra and into the bladder. Looking through the cystoscope, the urologist can examine the inner lining of the bladder and urethra for abnormalities.
  5. Prostate Specific Antigen or PSA may also be recommended for men of appropriate age.

How will hematuria be treated?

Treatment is based on the urologist’s evaluation of your condition, symptoms, and medical history along with the underlying cause of the hematuria.

Is follow-up recommended?

Even if no specific cause of the hematuria is found, some form of follow-up may still be necessary as studies have shown that a small percentage of urologic cancer are later discovered in patients with negative work-ups.

Our physicians at Georgia Urology provides full evaluations for hematuria in  many convenient  Atlanta area locations.