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There’s blood in my urine! What do I do?

hematuria blood in urine

The discovery of blood in your urine can be a frightening experience. Suddenly, a routine bodily function casts a shadow of concern, and the urgent question arises: “What do I do?” 

This alarming symptom, known as hematuria, ranges from a faint colour change to a distinct red tint, demanding immediate attention and action.

Unpacking Hematuria

Hematuria is more of a signal than a condition itself—like a red flag waved by your body. It’s the presence of red blood cells in your urine, categorised as either gross hematuria, which is visible, or microscopic hematuria, only detectable under a microscope. Both types, even when stemming from harmless causes, are signs that warrant medical attention.

The Spectrum of Causes

From the benign to the potentially severe, the reasons behind hematuria are varied. Infections such as urinary tract infections (UTIs) can lead to blood appearing in urine, as can the passage of kidney stones, which can graze the urinary tract lining. Other serious conditions, like cancers of the urinary system or kidney diseases, might also reveal themselves as hematuria. Exercise-induced hematuria is common among athletes, particularly those involved in high-impact sports. Moreover, certain medications, including blood thinners and some pain relievers, can increase the risk of bleeding. Dr Terence Lim, Senior Consultant and Medical Director of Assure Urology & Robotic Centre, warns that “Hematuria is often one of the first signs of cancers of the urinary tract such as kidneys, ureters or bladder cancers.”

Age-Related Concerns

The patient’s age significantly influences the possible causes of hematuria. Children might experience hematuria due to congenital urinary tract abnormalities, whereas adults may face it due to more varied reasons, including UTIs, trauma, or strenuous exercise. In older adults, the likelihood that hematuria indicates cancer or other serious conditions rises, guiding doctors toward more specific diagnostic procedures.

Diagnostic Journey

Finding the cause begins with a comprehensive medical history and physical examination, followed by urine tests to check for infection or kidney disease. Imaging tests, such as ultrasounds or CT scans, offer a closer look at the urinary system. Additionally, Dr Lim added that for some patients, a cystoscopy is performed, where a camera is inserted into the bladder for a direct visual inspection.

The Path Forward

If hematuria is due to an infection, doctors usually prescribe antibiotics. For kidney stones, treatments can vary from pain management and increased fluid intake to surgical intervention. If it is a more serious condition like cancer, the approach may include surgical removal, radiation, or chemotherapy, depending on the specific diagnosis. 

Dr Lim gives two situations where urgent medical attention is needed. He stated, “If the hematuria is severe, especially if there are passage of blood clots or if you are unable to pass urine or experienced severe pain on passing urine or fever, you will need to consult a doctor urgently. Also, blood in the urine without any other symptoms or associated with constitutional symptoms such as weight loss or appetite may be related to cancers. It will need a prompt medical consult.”

Preventive Measures and Ongoing Vigilance

While prevention of hematuria hinges on its underlying cause, staying well-hydrated and regular medical screenings can be generally helpful. For individuals with a hematuria history, ongoing monitoring is crucial for catching and addressing any new developments early.

In Summary

Blood in the urine is a symptom that should never be ignored. It’s a clear signal from your body that something needs medical evaluation. Hematuria might point to a benign issue that’s easily treated. However, it can also be the first sign of a more serious condition. Recognising this symptom as a prompt to seek medical attention is key. With the right care, most causes of hematuria can be managed effectively, safeguarding health and providing peace of mind. 

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