August 11, 2012 in Features, Health

Many possible causes for hematuria

Anthony L. Komaroff Universal Uclick

DEAR DOCTOR K: My doctor did a urine test and says I have hematuria. What is this? And what could have caused it?

DEAR READER: Hematuria is the presence of red blood cells in the urine. It means there is bleeding somewhere in your kidneys, your prostate (if you’re a man) or your bladder. If there are a lot of red blood cells, you will see them: They will turn your urine pink or red. If there are only a small number of red blood cells, you won’t see them, but they will show up when the doctor looks at your urine under the microscope.

There are many possible causes of hematuria.

• Strenuous exercise can produce blood in the urine, believe it or not. You won’t usually see it, but if you go to your doctor for a checkup right after exercising, blood may show up in your urine. This is harmless.

• A urinary tract infection in your bladder or kidney often causes hematuria, although it’s the pain with urination and having to go frequently, not a change in urine color, which is the most common reason that people call the doctor.

• Kidney stones can form inside the kidney and get stuck there or in the tubes draining the kidney, causing bleeding.

• Traumatic injury to any part of the urinary tract often causes hematuria.

• Bleeding disorders such as hemophilia can cause hematuria.

• Tumors in the kidney or bladder are what we worry about most when we see hematuria.

Depending on your symptoms, there are a number of tests your doctor is likely to order. These include a repeat urinalysis, a urine culture (to look for bacterial infection), or blood tests to check for signs of infection, kidney failure, anemia, bleeding disorders or conditions that lead to kidney stones.

The tests may be more complicated, such as a CT scan or an ultrasound to take a picture of your kidneys, ureters and bladder. The most complicated test is a cystoscopy, in which you receive anesthesia and have a tube passed into your bladder to look for tumors or other causes of bleeding.

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