Blood from the urine is called 'hematuria' in medical language. The condition in which blood in the urine is visible is called macroscopic hematuria, while the condition in which it can only be seen under a microscope is called microscopic hematuria.
What is Blood in the Urine (Hematuria)?
Blood in the urine or hematuria is the leakage of red blood cells into the urine. Normally, there should be no red blood cells (red blood cells) in the urine. Presence of more than a certain number of red blood cells in the urine sample examined under the microscope indicates microscopic hematuria. In macroscopic hematuria, blood in the urine is visible. In other words, a large number of red blood cells pass into the urine.
The presence of blood in the urine is a health problem that may occur due to many different reasons. In some cases, the appearance of blood in the urine may occur due to a temporary and relatively simple condition. However, sometimes bloody urine can indicate a serious health problem. Therefore, if blood is seen in the urine, it is necessary to consult a doctor.
In the case of urinary bleeding, the color of the urine may be pink, red or cola. Even a small amount of bleeding in the urine is usually enough to change the color of the urine. However, very small bleeding may not change the color of the urine. Bleeding in these patients can only be detected by urinalysis. As a result, hematuria symptoms may not always occur in patients, and blood in the urine can be noticed by laboratory tests. For example, a patient who has passed a kidney stone may have symptoms such as flank pain and nausea in addition to hematuria. . In people with hematuria complaints, various tests should be performed in order to find the problem causing the bleeding.
The most common causes of bloody urine can be listed as follows:
- Kidney Stone: Minerals such as calcium in the urine become concentrated and form crystals in organs such as kidney and bladder. These crystals solidify into stones over time. occur in the urinary tract Small stones are usually excreted in the urine without the person even being aware of it. However, stones that are slightly larger in size may obstruct the urinary tract and cause pain in the patient. Kidney stones can cause both macroscopic and microscopic bleeding by causing damage to the urinary tract.
- Urinary Tract Infections: An organ called the urethra allows urine to be thrown out of the body. Various microorganisms, especially intestinal bacteria, enter into this organ from structures such as the anus near the urethra. Bacteria entering from the urethra multiply towards the bladder, causing the development of urinary tract infection. Patients with urinary tract infections; It shows symptoms such as burning when urinating, foul-smelling urine, and frequent urge to urinate. When the infection reaches the kidney, it is called pyelonephritis. This condition is more serious than a simple urinary tract infection. The patient may experience symptoms such as fever, nausea, and flank pain. Urinary tract infections, including pyelonephritis, are among the causes of hematuria.
- Prostate Enlargement: The prostate gland is an organ found in men. The prostate gland is located below the bladder and is closely related to the initial part of the urethra, which runs along the penis in men. Especially from the age of 40s and 50s, the prostate gland begins to grow. The enlarged gland can press on the urethra, preventing urine output. In this condition, known as benign prostatic enlargement, in patients; It can lead to symptoms such as frequent urge to urinate, inability to empty the bladder completely, a sudden feeling of tightness and bleeding in the urine.
- Prostatitis: This condition, which means inflammation of the prostate gland, can also cause hematuria.
- Kidney Diseases: Glomerulonephritis is the filtering process of the kidney. It is a disease that occurs as a result of damage to the glomerulus structure. Glomerulonephritis; It can be part of a systemic disease such as diabetes, lupus, that affects the whole body. In addition, glomerulonephritis can be seen as a single disease. Many factors such as bacterial or viral infections, blood vessel inflammations (vasculitides), disorders in the immune system; may contribute to the development of glomerulonephritis lyre Hematuria is a common symptom in patients with glomerulonephritis.
- Genetic Diseases: Sickle cell anemia is a genetic disorder that causes deformity in red blood cells, that is, red blood cells. Kidney damage due to this disease can lead to blood in the urine. Alport syndrome can also cause hematuria by affecting the glomerulus structures responsible for the kidney's blood filtering function. Hemophilia, which causes a blood clotting disorder, can also cause bloody urine.
- Cancer: Kidney, bladder and prostate cancer can cause serious bleeding in the urine. However, this is usually seen when the cancer has reached an advanced stage.
- Injury: Kidney injury may occur as a result of accidents, physical violence or contact sports. These conditions usually cause a visible bleeding in the urine.
- Intense Exercise: As a result of heavy exercise, a noticeable bleeding can be seen in the urine, although rarely. Although the reason for this situation is not fully clarified, it is thought that events such as bladder damage, severe fluid loss during exercise or excessive destruction of red blood cells during long-term aerobic exercises may lead to bleeding. Exercise-induced hematuria is more common, especially in professional athletes.
- Medicines: Drugs such as penicillin, an antibiotic, cyclophosphamide, a cancer drug, aspirin and heparin, known as blood thinners, can cause bleeding in the urine.
How is the Treatment of Bleeding from the Urine?
When planning the treatment for hematuria, the condition that causes blood in the urine should be determined first. For this, first of all, the patient; Questions such as when the bloody urine complaint started, how often it is seen, and whether he has had such a problem before are asked. Afterwards, the patient is examined to see if there are signs such as pain, redness, swelling.
In order to detect the condition that causes hematuria, help is obtained from tests such as urinalysis, ultrasound or imaging with CT (Computerized Tomography). A procedure called cystoscopy can be performed to view the inner parts of the urethra and bladder. In this procedure, a thin tube with a camera at the end is passed through the urethra. delivered. Thus, it is checked whether there is any change in the inner walls of the urethra and bladder. The treatment of blood in the urine is based on the underlying condition.
In order to effectively treat the patient with hematuria due to kidney stones, the stone must be removed from the urinary tract. For this, drugs that increase urine output can be used. For larger stones, stone breaking or surgical procedures can be applied to the patients.
Antibiotics are used in the treatment of urinary tract infection. The patient is prescribed an antibiotic suitable for the urine culture result.
Alpha blockers or 5-alpha reductase inhibitors group drugs can be preferred for the treatment of prostate enlargement. In some patients, removal of the prostate gland with a closed surgical method (TUR) may also be a treatment option.
The treatment of cancers is planned according to parameters such as the general condition of the patient and the stage of the cancer. Cancer treatment usually includes long-term therapies using more than one method. It is useful to follow the patients for complications from an early period in diseases such as genetic diseases that have been present since birth.
Blood in the urine or hematuria may occur for different reasons. In order to diagnose and treat the disease that causes hematuria, a doctor should be consulted when blood is seen in the urine. It should not be forgotten that hematuria may develop due to serious health problems, and in the presence of such a complaint, necessary controls should be performed without delay.
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