Causative and risk factors
Plenty of causes can be responsible for passage of blood in the urine. Renal calculi are a common cause of hematuria. Internal trauma to the urinary tract caused as a result of instrumentation (catheterization or surgery) or external trauma to the pelvis can lead to hematuria. Other causes include urinary tract infections, cancer in the urinary tract, prostatitis, tuberculosis, glomerulonephritis or an enlarged prostate in men.
Clinical presentation
Sometimes the number of RBC’s passed in urine may be so less that it may not appear discolored to the naked eye. This is known as microscopic hematuria and can only be observed under a microscope. When a large number of RBC’s are passed in urine, the urine appears pinkish or reddish. Blood clots may be seen. Some patients experience pain while passing blood in urine, known as painful hematuria. Sometimes the passage of blood does not give rise to any pain, known as painless hematuria. Other symptoms will depend upon the cause of hematuria. Examples include fever, frequent urging to pass urine, incontinence of urine etc.
Investigations
A simple urine examination is performed to check the severity of hematuria and other abnormal constituents. Imaging studies such as an ultrasonography of the abdomen and pelvis is done to look for the cause of hematuria. A cystoscopy may be done to visualize the urinary bladder for any abnormal findings.
Treatment
The goal of treatment is to identify the cause of hematuria and treat it accordingly. Antibiotics may be prescribed in cases of urinary tract infections. Renal stones may be removed with the help of hydrotherapy or lithotripsy. Cancers are usually treated with a combination of surgery, radiation therapy and chemotherapy.
