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What is Hematuria? Hematuria, also known in the medical world as “erythrocyturia” or simply “blood in urine”, is a health condition where there happens to be the presence of blood in the urine. Red blood cells enter and mix with the urine through various sites and mediums. These anatomical sites may include the kidneys, bladder, […] Read More

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What is Hematuria? Hematuria, also known in the medical world as “erythrocyturia” or simply “blood in urine”, is a health condition where there happens to be the presence of blood in the urine. Red blood cells enter and mix with the urine through various sites and mediums. These anatomical sites may include the kidneys, bladder, urinary tract, prostate (in men), female reproductive system, and integumentary system.  Anyone, including children, can stand the risk of having hematuria, though males of 50 years and above are more vulnerable to the infection (due to the enlargement of the prostate).  There are various types of hematuria, and some of them include:
  • Gross Hematuria 
In this type, the urine appears pink, red, or cola in color, due to the presence of ruptured red blood cells (RBG, as some know it) in the urine. This type of hematuria is visible and may or may not be painful, depending on the amount of RBGs in the body, as blood clots are painful to pass out during urination. 
  • Microscopic Hematuria 
This is when we cannot physically see the blood in the urine with our eyes, except with the use of a microscope. Most people with this type of hematuria show no symptoms whatsoever. Aged people mostly encounter this type of hematuria, whereby the blood flows painlessly and almost unnoticed.
  • Idiopathic Hematuria
When a high number of red blood cells are present in the urine, and without any reasonable underlying cause, it may be termed as this type of hematuria. Ideally, no treatment may be required in this case. Other types can include:
  • Stress hematuria; blood in the urine that occurs when you are under a lot of stress from undergoing very strenuous activities.
  • Painless hematuria; a case where hematuria occurs without any pains. There may be traces of blood in urine, but in most cases, there are no symptoms at all–the blood is microscopic and unnoticeable.
  • Painful hematuria; where blood in urine occurs with a lot of pains.
Diagnosis To diagnose, a chemically treated paper strip (called a dipstick) is placed in a urine sample (called a urinalysis). If red blood cells are present, patches on the dipstick will change color. Further examination is done under a microscope, to check if the red blood cells are noted in the urine. The doctor may order further testing, such as: Treatment Hematuria is not a disease but is identified as a symptom of certain conditions. Therefore, there is no cure and no treatment that can work on urine in the blood directly. Exercise-induced hematuria or stress hematuria can go away on its own, within 24 to 48 hours. Hematuria resulting from urinary tract infection will likely disappear when the infection is cured, and the urinary infection can be treated with antibiotics. A urinalysis should be repeated six weeks after the antibiotic treatment ends, to make sure the infection is gone. Recovery For stress hematuria, the recovery rate is 24 to 48 hours. For microscopic hematuria, it depends on how long it takes the infection to respond to antibiotics. As for the idiopathic type (which cannot be traced to a simple cause), it is prudent for the patient to be monitored regularly and patiently. In any case of recurrence, another cycle of evaluation would be necessary. Since hematuria is the result of various processes, its rate of mortality depends on the primary process which initiates it. However, while those with exercise-induced, microscopic, and gross hematuria bear no risk of death, those associated with hypertension or proteinuria may not, hence needing intensive medical care.


Symptoms Of Hematuria

This infection has some signs and symptoms, some may come with pains, while others may not. 

The painful symptoms most likely include:

  • Nauseated fever
  • Abdominal pains
  • Persistent urge to urinate
  • Painful urination
  • Burning urine
  • Strong smelling odor in the urine.

However, there is one major painless symptom of hematuria that mainly occurs in older adults; the microscopy of blood in the urine. 


Causes Of Hematuria

Blood in the urine is not a disease per se, but rather it is a sign or symptom of a condition or the effect of another condition or reactant. 

Some of the causes of the condition include:

  1. Infection in some body organs, via:
  • Urinary tract
  • Kidney
  • Bladder
  • Ureter
  • Male prostrate
  • Urethra
  1. Kidney/bladder stones
  2. Menstruation
  3. Sex
  4. Injury
  5. Family history of kidney disease
  6. Strenuous exercise
  7. Bacterial/viral infection
  8. Kidney or bladder cancer
  9. Kidney irritation/swelling
  10. Blood clots
  11. Sickle cell disease
  12. Polycystic kidney disease (PKD)
  13. Enlarged prostate
  14. Medications, such as;
  • Anticancer drugs
  • Cyclophosphamide such as Cytoxan
  • Penicillium, etc.


What is the most common cause of microscopic hematuria?

The most common causes of this type of hematuria include:

  • Urinary tract infection (also called UTI),
  • Benign prostate hyperplasia, and,
  • Urinary calculi.

 What is Jogger's hematuria?

This is a special type of hematuria which results from the jarring of the bladder, repeatedly, during jogging or long-distance race. Reddish urine that is not caused by blood, on the other hand, is termed as ‘pseudohematuria’.

What is painless hematuria?

This is also a special type of hematuria which, in this case, is however associated with underlying malignancies.

Hematuria associated with pain may be more likely to be of stone diseases like urinary calculi or urinary tract disease.Blood at the start of the urinary stream, however, may be likely due to the lower urinary tract disease, but not diagnostic.

 Am I at risk of having hematuria? 

If you are an older man of 50 years and above, or a woman with a urinary tract infection, then you are most likely to be prone to the sign. 

Athletes and sexually infected persons are also prime targets of the symptoms of hematuria. Furthermore, if you come from a family with a medical history of kidney, bladder, or urinary problems, then your case might not be different, most likely.


How common is hematuria?

In adults, the prevalent rate of microscopic hematuria ranges from 0.19 to 21%.