Hematuria is the presence of blood in the urine. It is often classified as “gross hematuria” if it can be visibly seen by the naked eye, or as “microscopic hematuria” if detected by urine studies only.
Hematuria can be seen in both males and females. Many conditions can lead to presence of blood in the urine including:
- Urinary tract infection (UTI)
- Kidney or bladder stones
- Enlarged prostate
- Prostate infection or inflammation
- Radiation cystitis
- Interstitial cystitis
- Medications (blood thinners)
- Cancers of kidney, ureter, bladder or prostate
- Intrinsic kidney disease (nephropathy)
Your doctor will discuss the potential causes specific to your health. For urologists, a diagnosis of hematuria without known infection or stone is considered malignancy until proven otherwise. Therefore, we will evaluate your laboratory results, order imaging of the kidney and ureter (often CT, Ultrasound or MRI), and evaluate your bladder with a camera (known as cystoscopy) to rule out cancers of urinary tract.
Cystoscopy (photo below) is an office procedure in which a camera (about the size of a foley catheter) will be passed through your urethra into your bladder to meticulously inspect your bladder for evidence of masses, lesions or stones. This procedure takes less than 20 minutes and you will be able to go home immediately after this procedure. A urine washing may be sent during the procedure to evaluate for abnormal cells.
If an underlying cause is discovered, your doctor will discuss with you the options for treatment.
If no underlying cause is discovered, you will be monitored with routine urine studies until negative results are found. If urine studies remain positive, repeat workup may be recommended every three years.