Hematuria is the presence of Red blood (blood) cells in urine. Remember, consider presence of blood in urine in women during their menses as false positive.
Traumatic – accidents, injury to the pelvic region and during catheterization. Never catheterize in hematuria since it passes through prostatic vessels and the patient can further bleed clots.
Tumors as one of the most common causes of hematuria. Transisitional cell carcinoma accounts for 95% of the cases.
Drugs such as warfarin, heparin and aspirin interfere with clotting.
Bleeding disorders such as haemophilia A and B, von will brand disease etc.
Infections such as urinary tract infection, bilharzia and schistosomiasis.
Some causes are idiopathic meaning are not known.
Remember that rifampicin drug causes reddening of the Urine.
Classification of Hematuria.
Painful mainly bleeding from upper urinary tract. Painless mainly from lower urinary tract.
Microscopic only visible during urinalysis. Macroscopic frank blood during urination.
Initial usually from urethra and bladder, terminal bladder neck contraction from schistosomiasis or total or frank urine throughout.
When you see your doctor due to presence of blood in urine, proper history would be taken and examination would be done to try identify the cause of hematuria as above.
Investigations will depend on the findings of the doctor. Urinalysis, renal and bladder ultrasound among many other investigations might be ordered.
Treatment of hematuria depends on the cause. If a lot of blood has been lost resuscitation might be needed. If on drugs causing blood in urine as mentioned above, they will be stopped. Infections will be treated appropriately. Tumors management depends on the stage.
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