myUpchar प्लस+ के साथ पूरेे परिवार के हेल्थ खर्च पर भारी बचत

Summary

Presence of blood in the urine is an alarming symptom. Urine that contains blood is often associated with other symptoms, such as pain during urination, fever, nausea, and vomiting. A person complaining of blood in the urine needs to undergo a thorough clinical evaluation to determine the underlying cause. Furthermore, specific blood and urine tests are needed to determine the exact cause. An X-ray or ultrasonography of the abdominal and pelvic area might also be needed for diagnosis. The causes of blood in the urine could range from a simple mild urinary tract infection (UTI) to kidney stones or complex diseases, such as cancer. The treatment for each case of blood in the urine will depend on the cause. Some people may recover with a short course of antibiotic medicine while a few may require surgery. The outcome is usually very good with rare chances of developing complications.

  1. What does it mean to get blood in urine
  2. Types of blood in urine
  3. Blood in urine symptoms
  4. Blood in urine causes and risk factors
  5. Prevention of blood in urine
  6. Diagnosis of blood in urine
  7. Blood in urine treatment
  8. Blood in urine prognosis & complications
  9. Medicines for Blood in Urine
  10. Doctors for Blood in Urine

What does it mean to get blood in urine

The medical term for the presence of blood in the urine under is haematuria. It may or may not be accompanied by other symptoms. It may be transient or persistent for long periods, or may be an isolated feature. Sometimes, there may be a presence of proteins (proteinuria) in the urine along with haematuria.

It indicates that there is an underlying problem in the urinary or genitourinary system that triggers bleeding. Blood in the urine is usually harmless in many cases, but sometimes can be an alarming symptom of a serious disease. Several diseases such as UTIs and kidney stones can lead to blood in the urine. However, other pathologies must also be considered in cases of chronic blood in the urine. If the doctor rules out benign reasons that may cause blood in the urine, other investigations are advised to rule out more serious causes.

Types of blood in urine

There are two types of blood in urine:

  • Macroscopic Haematuria
    If the urine appears red to the naked eye, it is known as macroscopic haematuria. Even 1 mL of blood in the urine can give it a reddish tinge. Macroscopic haematuria should be thoroughly examined, as it is of a major concern. The incidence of macroscopic haematuria ranges from 1-6 % but has also been as high as 19%. UTIs and kidney infections known as pyelonephritis are said to be the most common causes of macroscopic blood in the urine.
  • Microscopic Haematuria
    If blood is only detected after the examination of the urine under a microscope, it is termed microscopic haematuria. Alternatively, more than 10 red blood cells should be detected on a high field microscopic evaluation to be termed as microscopic haematuria.

Blood in urine symptoms

Blood in the urine is an accompanying symptom of an underlying condition. Symptoms specific to certain conditions may be associated with blood in the urine.

Blood in urine causes and risk factors

Causes

Macroscopic, as well as microscopic blood in the urine, can be a common feature of benign as well as malignant (cancerous) conditions of the urinary system. The main causes that lead to blood in the urine are as follows:

  • Urinary Tract Infections
    UTIs can occur in any region of the urinary system. A majority of the infections are related to the lower urinary tract, which includes the urinary bladder and urethra. The risk of UTIs is higher in women than in men because women have a smaller urethra than men, and the distances from the urethra to the bladder and the urethra to the anus are also shorter than those in men. Also, as the vagina is close to the urethral opening, sexually transmitted infections, herpes, or gonorrhoea can also cause UTIs. Women after menopause may also be more susceptible to infections due to a fall in the oestrogen levels. Escherichia coli, a bacterium usually found in the gastrointestinal tract, is the most common organism causing UTI. In most instances, a person can recover from a UTI after taking medicines, but there can be serious complications if the infection spreads to the kidneys. 
  • Kidney or Bladder Stones
    Hardened deposits of salts and minerals that are formed within the bladder and kidneys are known as stones. It can affect any part of the urinary tract. When the urine becomes concentrated, the minerals begin to crystallize and harden, forming a stone. Kidney stones are mainly formed of calcium oxalate. Oxalates are found naturally in the body and are made by the liver. Certain foods, such as chocolates and nuts, have high oxalate content. People following a diet high in proteins, sodium or sugar may increase the risk of stones. Obesity is also associated with a higher risk of kidney stones. It can be painful while passing stones in the urine and the passage may be blocked by stones if they are large enough. If stones obstruct the urinary tract, it may lead to infections and other complications. Usually, kidney stones do not produce any symptoms unless they are moving in the kidney or travel into the bladder or ureter.
  • Kidney Infections
    Kidney infections, also known as pyelonephritis, begin as a urinary infection and spread into the bladder or kidneys. The bacteria entering the urinary tract multiply and travel upwards. Infections from other places in the body can also spread through the blood into the kidneys. Women, particularly pregnant women, are at a higher risk of infections. Conditions, such as kidney stones, enlarged prostate, diabetes, HIV, and spinal cord injury increase the risk of kidney infections. Kidney infections need to be treated immediately, or they may lead to further complications, which can damage the kidneys. The bacteria causing the infection may enter the bloodstream and may cause life-threatening complications.
  • Enlarged Prostate Gland
    Prostate gland enlargement is a common condition in older males. An enlarged prostate can lead to difficulty while urinating and block the urinary bladder leading to kidney diseases. The urethra passes through the centre of the prostate gland situated beneath the bladder. When the gland is enlarged, it blocks the flow of urine. The exact cause of prostate enlargement remains unknown, but male sex hormones probably influence the growth of the gland. Certain risk factors, such as advanced age; a family history; and certain diseases, such as high blood pressure, diabetes, and obesity, increase the risk of prostate enlargement.
  • Cancers
    Almost 9 out of 10 kidney cancers are renal cell carcinomas. However, most kidney cancers are detected before spreading to other organs, and such cases respond better to treatment. Bladder cancers are rarer than kidney cancers.
  • Other causes
    • Uric acid stone.
    • Pelvic trauma.
    • Menstruation.
    • Sexual activity.
    • Foreign bodies.
    • Radiation.
    • Kidney and prostate biopsies.
    • Cancer.
    • Kidney injury from accidents or blow or sports.
    • Medications for cancer or anticoagulants, such as aspirin or blood thinners.
    • Exercise, although rare, can also lead to blood in the urine.
    • Sickle cell anaemia.
    • Use of catheter for extended periods of time or traumatic catheterisation.
    • Stents in the ureter.

Risk factors

Risk factors help determine people who are prone to certain urinary conditions, which in turn, may lead to blood in the urine:

  • Men older than 50 years complaining of blood in the urine due to an enlarged prostate gland.
  • A positive family history of kidney cancers or kidney stones.
  • A strong history of chronic bladder inflammation (cystitis) or lower urinary tract infections.
  • History of gross blood in the urine.
  • People on aspirin; painkillers; blood thinners; or antibiotics, including penicillin have a high risk of kidney and urinary bleeding.
  • Long distance runners or persons who work out rigorously are prone to exercise-induced blood in the urine.
  • Exposure to chemicals and dyes increases the risk of urinary tract cancers.

Prevention of blood in urine

There are several measures that can be taken to decrease the risk of urinary conditions. These include:

  • Drink plenty of fluids
    An intake of 10 to 12 glasses of water daily helps flush out bacteria and other toxins during urination.
  • Urinate when needed
    It is best not to delay the urge to urinate, as holding the urine for too long will pool the bacteria, leading to infections.
  • Urinate after sexual activity
    Emptying the bladder immediately after intercourse will flush out the bacteria from the urethra, decreasing the risk of infections.
  • Maintain hygiene of the genital area
    After urination or defecation, clean the area from front to back to prevent the re-entry of bacteria into the urethra.

Diagnosis of blood in urine

It is important to find out the underlying cause of the presence of blood in urine. To do this, your doctor will carry out various diagnostic tests, which include:

  • Medical History and Physical Examination
    This includes a complete medical history, including past and family history, along with a detailed physical examination.
  • Blood Examination
    Blood tests can reveal the presence of infections if the white blood cell count is increased. Besides this, it may also reveal the presence of bacteria that have spread into the bloodstream and have led to a condition known as sepsis. Presence of chemical compounds such as calcium and uric acid, can reveal gout and kidney stones. The levels of a specific protein called prostate-specific antigen are elevated in the enlargement, infection, or cancer of the prostate gland.
  • Urine Examination
    A urine examination and culture will check for blood cells, pus cells, other bacteria, and minerals, which can help diagnose conditions, such as UTIs and kidney stones. Sometimes a 24-hour urine sample may also be required to check for stones. Before further investigations are performed, it is advised that at least 2 out of 3 samples should show the presence of red cells over 3 weeks of examination.
  • Urine Culture
    Along with a urine examination, a urine culture test would help determine the bacteria causing the infection to enable appropriate treatment initiation.
  • Cystoscopy
    A cystoscopy is an examination to visualise the urethra and bladder. An instrument called cystoscope is used to check for stones or recurrent infections.
  • Imaging Studies
    Studies, such as ultrasonography, magnetic resonance imaging (MRI), and computed tomography (CT) scan can detect kidney stones, tumours, or small masses within the urinary system.
  • Biopsy
    Occasionally, doctors may perform a biopsy, wherein a small tissue sample is collected to look for advanced stages of kidney diseases or cancers.

People in whom the cause of blood in the urine cannot be determined, further specific investigations may be conducted to rule out malignancies.

Blood in urine treatment

Treatment

  • Medication
    For uncomplicated infections, a short course of antibiotics is prescribed. Sometimes, painkillers are prescribed to relieve pain and burning while urinating along with antibiotics. In some conditions, a low dose of antibiotics for 6 months is given. In postmenopausal women, hormone oestrogen therapy might also be given.
  • Surgery
    Surgery may be carried out in people who do not respond well to antibiotics and other medications. Procedures to remove larger kidney stones, blockages and tumours may be performed.

Lifestyle management

The following tips can help ease the discomfort a person may experience with their urinary conditions:

  • Stay hydrated
    Drinking adequate amounts of water or 10 to 12 glasses daily is recommended to keep the urine diluted and remove toxins.
  • Use heating pads
    A heating pad will ease the discomfort or pain in the bladder region.
  • Avoid caffeine and other stimulants
    Caffeine or alcohol can irritate the bladder and increase the urge to urinate; hence, it is best to avoid them until the infection is treated completely.
  • Opt for a healthy diet
    A balanced diet consisting of fresh fruits and vegetables should be encouraged. Fatty foods and fried items, lead to obesity, which is linked to prostate diseases.
  • Try herbal supplements
    Certain herbal products, such as ryegrass and cranberry juice, may help in reducing urinary infections. Before beginning on herbal supplements, it is best to take the advice of the doctor.

Blood in urine prognosis & complications

Prognosis

The outcome of blood in urine depends on the underlying cause. Mild urinary infections can be treated with a course of antibiotics and resolve faster than long-term infections. The outcome of kidney stones will be better than that of kidney or bladder cancers.

Complications

The complications associated with conditions leading to blood in the urine are as follows:

  • Recurrent UTIs.
  • Chronic bladder dysfunction.
  • Prostate cancer.
  • Metastasis (the spread of cancer to other organs).
  • Bladder obstruction.
  • Hydronephrosis (abnormal dilatation of the tubes of the kidney due to back pressure created by the kidney stones or a tumour or an obstruction).
Dr. Virender Kaur Sekhon

Dr. Virender Kaur Sekhon

यूरोलॉजी

Dr. Rajesh Ahlawat

Dr. Rajesh Ahlawat

यूरोलॉजी

Dr. Prasun Ghosh

Dr. Prasun Ghosh

यूरोलॉजी

Medicines for Blood in Urine

Medicines listed below are available for Blood in Urine. Please note that you should not take any medicines without doctor consultation. Taking any medicine without doctor's consultation can cause serious problems.

Medicine NamePack SizePrice (Rs.)
HemsylHemsyl 125 Mg Injection27
Bjain Sabina LMBjain Sabina 0/1 LM39
ADEL Sabina DilutionADEL Sabina Dilution 1000 CH144
Bjain Lespedeza sieboldii DilutionBjain Lespedeza sieboldii Dilution 1000 CH63
Dr. Reckeweg Sabina DilutionDr. Reckeweg Sabina Dilution 1000 CH136
ADEL Pareira Brava Mother Tincture QADEL Pareira Brava Mother Tincture Q 184
Bjain Pareira brava Mother Tincture QBjain Pareira brava Mother Tincture Q 319
Schwabe Lespedeza sieboldii CHSchwabe Lespedeza sieboldii 1000 CH96
CosklotCosklot 250 Mg Injection32
DicyneneDicynene 125 Mg Injection29
ADEL Sabina Mother Tincture QADEL Sabina Mother Tincture Q 208
EklotEklot 125 Mg Injection15
EthasylETHASYL INJECTION191
K StatK Stat 125 Mg Injection28
Revici ERevici E 250 Mg Tablet73
SBL Ferrum muriaticum DilutionSBL Ferrum muriaticum Dilution 1000 CH86
SylateSYLATE-T 500MG TABLET312
SBL Mezereum DilutionSBL Mezereum Dilution 1000 CH86
SylSyl 250 Mg Injection16
AcmesylateAcmesylate Injection18
Schwabe Pareira brava MTSchwabe Pareira brava MT 148
Schwabe Sabina CHSchwabe Sabina 1000 CH96
AlstatAlstat 250 Mg Injection32
Coastat PlusCoastat Plus 500 Mg/250 Mg Tablet80
SBL Sabina Mother Tincture QSBL Sabina Mother Tincture Q 145

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References

  1. American Kidney Fund [Internet] Maryland, United States; Blood in urine
  2. Melissa Yeoh Nai Kid Lai Daniel Anderson Vinesh Appadurai. Macroscopic haematuria. The Royal Australian College of General Practitioners [Internet] A urological approach Volume 42, No.3, March 2013 Pages 123-126. Australian Family Physician
  3. PP Varma, T Mohanty. Approach to Hematuria. The Association of Physicians of India [Internet]
  4. Elbouaeshi A, Rayani A, Irheem M, Habas E. Causes and diagnostic significance of macroscopic hematuria in children and young adults. . Libyan Journal of Medical Sciences. 2017 Jul 1;1(3):72. [Internet]
  5. Antoniewicz AA, Zapała Ł, Poletajew S, Borówka A. Macroscopic hematuria—a leading urological problem in patients on anticoagulant therapy: is the common diagnostic standard still advisable?.. ISRN urology. 2012 Apr 1;2012. [Internet]
  6. National Institute of Diabetes and Digestive and Kidney Diseases [internet]: US Department of Health and Human Services; Kidney Stones.
  7. Shlomo Melmed Kenneth Polonsky P. Reed Larsen Henry Kronenberg. Williams Textbook of Endocrinology. 12th Edition St. Louis. Missouri: Elsevier Saunders; 27th May 2011
  8. American Cancer Society [Internet] Atlanta, Georgia, U.S; What Is Kidney Cancer?.

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