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What is Hematuria - Blood in the Urine? Print E-mail
Written by Gary Presant, MD   
Tuesday, 20 October 2009

Blood in the urine can be visible, or it may only be noticed when the urine is tested.

What is going on in the body?

Not all cases of dark or red urine are due to blood in the urine. Muscle breakdown, eating a large amount of beets, or taking the antibiotic rifampin can all turn the urine dark or red. True blood in the urine can only be confirmed when red blood cells are seen in the urine with a microscope. There are many possible causes of blood in the urine.

What are the causes and risks of the condition?



There are many possible causes of blood in the urine, including:
- benign prostatic hyperplasia, or an enlarged prostate, a common condition in men over age 40
- bladder infections such as acute cystitis or recurrent cystitis
- bleeding or blood-clotting disorders, such as hemophilia A or hemophilia B. Clotting problems may also be seen in a person who is taking too much of the blood-thinning drug warfarin.
- infection in the urethra, known as urethritis. The urethra is the tube that carries urine from the bladder to the outside of the body.
- kidney damage, such as from the condition called glomerulonephritis. In children, this damage is commonly due to an infection with Group A streptococcus, commonly known as a strep infection.
- kidney infection, known as pyelonephritis
- a kidney stone, which is usually quite painful
- sickle cell disease, an inherited condition usually seen in African American people. It results in abnormally shaped red blood cells, which can damage the kidney.
- a tumor or cancer, most commonly in the kidney, bladder, or prostate

Other causes are also possible. Sometimes, no cause can be found.

What are the treatments for the condition?

Treatment is directed at the cause. A person who has a kidney stone is often given lots of fluid and pain medicines, and the stone usually passes on its own. If it doesn't, surgery or another procedure such as endoscopy may be needed to remove the stone. A person with an infection may be given antibiotics, while someone with a tumor or prostate enlargement may need surgery.

What are the side effects of the treatments?
Side effects depend on the treatments used. Antibiotics can cause an allergic reaction or stomach upset. Pain medicines may cause drowsiness or allergic reactions. Any surgery carries a risk of bleeding or infection.


What happens after treatment for the condition?
Treatment usually cures a person who has an infection or a kidney stone, and the person can resume normal activities. Someone with cancer may die if treatment is not successful. People with sickle cell disease often need fairly close monitoring and treatment for flare-ups of the disease throughout life.

How is the condition monitored?
Urine can be tested with a urinalysis and urine culture until blood is no longer seen. Other monitoring is related to the cause. For example, a person who takes warfarin often needs frequent prothrombin time, or PT, blood tests. Any new or worsening symptoms should be reported to the healthcare provider.

 

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