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Hematuria is a condition where red blood cells are present in the urine. There are two types: ‘visible microscopic’ and ‘visible gross’ hematuria. Microscopic hematuria refers to an incidental finding, usually discovered in a urine test conducted as part of a routine medical examination. Gross hematuria, on the other hand, will probably prompt you to see the doctor because of its visibility. Hematuria can originate from any area of the urinary tract, including the bladder, kidneys, ureters, urethra and prostate. It is believed that hematuria occurs in anything from 2.5% to 21% of the population. Often, no specific cause can be identified, but it could be an indication of infection, stone disease or urinary tract cancer. Risk factors for significant underlying disease include radiation, smoking, overuse of certain pain medicines and exposure to some chemicals.
What are the common causes of hematuria?
Having blood in the urine is not necessarily a sign of significant disease. Studies have shown that between nine and 18 percent of normal individuals have hematuria to some extent. However, it could be a sign of a serious condition that needs medical treatment. Below is a list of common causes of hematuria:
- Bladder/kidney/ureteral/urethral/prostate cancer
- Urinary tract infection
- Urinary stone disease
- Kidney infection (pyelonephritis)
- Benign prostatic hypertrophy (enlarged prostate)
- Prostatitis (prostate infection)
- Renal (kidney) disease
- Radiation or chemical-induced cystitis (bladder irritation)
- Urinary tract injury
- Exercise hematuria
How is hematuria diagnosed?
While gross visible hematuria often prompts patients to seek medical attention; less obvious microscopic hematuria can be just as serious. It often has no symptoms and is detected on a urine dipstick test. If the dipstick test is positive for blood, the proportion of red blood cells is often determined by examining the urine under a microscope. If a microscopic examination finds three or more red blood cells per high power field on two of three specimens, further evaluation to identify a cause is recommended.
