The passing of blood during urination is a common condition known as urinary bleeding, or hematuria. Individuals may experience urinary bleeding for a variety of reasons that may be behavioral or medical in nature. Since there is no single, established treatment for a hematuria, treatment is dependent on the underlying cause for the urinary bleeding.
There are two presentations associated with urinary bleeding. Microscopic hematuria is the passing of blood in urine which is invisible to the naked eye. Only detectable under a microscope, this form of hematuria may be detected during routine testing or evaluations for secondary conditions. Bleeding that is visible is known as gross hematuria.
Several factors may contribute to the passage of blood during urination. The urinary tract is comprised of several organs, including the bladder, kidneys, and urethra. A hematuria occurs when blood cells are allowed to pass into urine that is expelled through the urethra. Any of the organs associated with the production, storage, or passage of urine may leak blood cells.
Urinary tract infections are the most common condition associated with the development of a hematuria. Additional conditions such as kidney disease, cancer, and an enlarged prostate may contribute to the development of a hematuria. Common issues affecting the kidneys, such as stones and bacterial infections like pyelonephritis, may also cause bleeding. Regular use of certain over-the-counter and prescription medications, such as aspirin and penicillin, may contribute to the passing of blood. Strenuous exercise, the consumption of certain foods, and injury to the kidney region can also cause a gross hematuria to occur.
Individuals with urinary bleeding may pass urine that is red, pink, or brownish in color. The darkened hue of the urine is due to the presence of the leaked blood cells. Generally, symptomatic individuals experience no pain and present no other symptoms. Although, in cases where blood clots develop, individuals may experience some pain when the clots pass in the urine. Although some instances of a hematuria may be temporary and benign in nature, a medical consultation and testing should be sought as a precautionary measure for persistent symptoms.
There are several diagnostic tests that may be performed in addition to a physical examination to determine the underlying cause of a hematuria. A urinalysis may be performed to check for signs of infection or mineral markers indicative of the presence of kidney or bladder stones. Imaging testing, such as a computerized tomography (CT) scan, magnetic resonance imaging (MRI), and ultrasound, may be conducted to evaluate the condition of the bladder and kidneys. In some cases, a cystoscopy may be necessary to more closely assess the urethra and bladder. Sometimes the cause for a hematuria may be elusive, necessitating regular monitoring and periodic testing.
Treatment for a hematuria is entirely dependent on its underlying cause. The use of antibiotics and anti-inflammatory medications may be necessary in the presence of an urinary tract infection or kidney disease. Other conditions, such as cancer and inherited disorders, may require extensive treatment that may include the use of drug therapies, surgery, and blood transfusions.
Though a hematuria can affect anyone of any age, there are some individuals who may be at an increased risk for this condition. Individuals who are recovering from a kidney infection, taking certain prescription medications, or who have a family history of kidney stones or disease may be more likely to become symptomatic. Additionally, those who participate in contact sports or regularly adhere to a strenuous exercise regimen may increase their risk of developing a hematuria due to injury or exertion. Drinking plenty of water, maintaining a healthy body weight, and consuming a healthy, balanced diet may reduce one’s risk for developing conditions that may contribute to the development of a hematuria. Smoking cessation, staying active, and avoiding environments that foster exposure to toxic chemicals may also reduce an individual’s risk for developing conditions that may lead to urinary bleeding.