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Blood in the Urine (Hematuria)

Blood in the urine, or hematuria, is a fairly common event with about 10% of people experiencing it. Blood in the urine can be visible to the naked eye as bright red or brown in color, or can be present microscopically. The presence of blood means that bleeding is occurring somewhere in the genito-urinary tract; that is in the kidneys, ureters, the prostate gland, the bladder or the urethra.

Hematuria may be a sign of a serious medical disorder which requires medical investigation. The amount of blood loss is not necessarily an indication of the seriousness of the disorder. When blood is mixed with urine it is sometimes difficult to judge the gross loss.

Common Causes of Hematuria

The most common causes of hematuria are kidney and bladder stones, trauma to the kidney, bladder, or other parts of the genito-urinary tract. Anything from “joggers hematuria”, kidney disease, sexually transmitted diseases, benign prostate hypertrophy, viral infection of the urinary tract, tumours and blockages, as well as some medications (e.g. phenytoin, quinine, rifampin) can cause a bleed.

Rare Diseases Causing Hematuria
Diseases and genetic disorders causing blood loss in the urine include sickle cell anemia – an inherited blood disorder affecting native Africans; Von Hippel-Landau disease, an inherited disorder in which benign tumors grow on the kidneys, testicles and spine; and systemic lupus erythatosus, a chronic inflammatory disease of the connective tissue.

Diagnosis and Tests
There are a number of tests that, when combined with a physical examination and medical history, will help your doctor make an accurate diagnosis. These can include a simple urine dipstick test that detects the presence of blood, a urine culture that shows up any infection, blood chemistry tests that will demonstrate, amongst other things, kidney function. Microscopic examination may detect cancer cells.

IVP: an intravenous pyelogram, is an X-ray test where a dye containing iodine is tracked on its journey through the genito-urinary system showing up any abnormalities.

Cystoscopy: a flexible fiber optic tube can be introduced so that the doctor can see any abnormalities may require treatment.

Ultrasound and CAT: (computer assisted tomography) may be required for further investigation if the above tests fail to find a cause.

Treatment for Hematuria
Treatment is dictated by cause, so may comprise, for example, antibiotics, surgery or medication review.

Sometimes a pink or red color can be due to diet, eating excessive amounts of rhubarb, beets or even food coloring. However in most cases a bright red or brown color indicates blood loss.

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