Blood in the urine


From Hemat = blood and uria = of urine
Hematuria simply means blood in the urine. Microscopic hematuria means that the blood is only seen when the urine is examined under a microscope. Gross hematuria, on the other hand, means that there is enough blood in the urine so that the change can be appreciated with the naked eye. Obviously, gross hematuria has more blood in the urine than microscopic hematuria, but the types of diagnoses that can cause the problem are the same and the work-up or evaluation that is needed is identical.

The number of causes of hematuria is great — perhaps 20 or 25 different groups of causes.
Some are much more serious than others and require diagnosis sooner that later. These groups include cancers or malignancies, stones, infections, and blockages or obstructions to flow.

In the case of cancers, one must be concerned with every organ in the urinary tract, thus the reason to look at the entire urinary tract. Of the other groups, many are less important and most require no treatment. These may include viral infections, non-specific inflammations of the kidney such as drug reactions (non-steroidal anti-inflammatory drugs, such as ibuprofen can cause non-specific inflammation, usually without harm). Many medications can cause blood in the urine, particularly medications which thin the blood’s clotting ability, like coumadin or aspirin.

To understand the needed evaluation for hematuria, one must know the anatomy of the urinary tract in The kidneys function to make urine by filtering the blood and discarding into the urine the waste products that are no longer needed. Water and salts accompany these waste products by necessity. The urine is then transported through two narrow tubes, called ureters, to the bladder, which is the reservoir for urine in between each void. The urine exits the bladder through a channel called the urethra that first passes through the prostate and then through the penis to the outside.
The blood in the urine must come from one of the above places: kidneys, ureters, bladder, prostate, or urethra. The evaluation requires that we look at the ENTIRE urinary tract in patients with hematuria.


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