What Can Cause Blood In The Urine – “Gross hematuria” occurs when the urine appears red, brown or tea-colored due to the presence of blood. Hematuria can also be subtle and can only be detected with a microscope or a lab test.

The blood that mixes and mixes with the urine can come from anywhere in the urinary system, including the kidney, ureter, bladder, urethra, and, rarely, the prostate.

What Can Cause Blood In The Urine

Common causes of hematuria include urinary tract infection (UTI), kidney stones, viral illness, trauma, bladder cancer, and exercise.

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These causes are grouped into glomerular and non-glomerular causes, depending on the involvement of the glomerulus of the kidney.

Other substances such as certain medications and foods (eg, blackberries, beets, food dyes) can cause your urine to appear red.

Training in women may also cause hematuria and may result in a positive urine test for hematuria.

A dipstick urine test may also give a false positive for hematuria if other substances are present in the urine such as myoglobin, a protein excreted in the urine during rhabdomyolysis. A positive urine dipstick test should be confirmed by microscopy, where hematuria is defined by three or more red blood cells per high-power field.

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When hematuria is detected, a thorough history and physical examination with appropriate additional evaluation (eg, laboratory tests) can help determine the underlying cause.

Many causes can present as visible hematuria or microscopic hematuria, so the differential diagnosis is often organized around glomerular and nonglomerular causes.

Although the urine dipstick test is capable of recognizing heme in red blood cells, it also identifies free hemoglobin and myoglobin.

Free hemoglobin can be found in urine resulting from hemolysis, and myoglobin can be found in urine resulting from rhabdomyolysis.

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Thus, a positive dipstick test does not necessarily indicate hematuria; rather, urine microscopy showing three or more red blood cells per high-power field confirms hematuria.

In women, the instruction may cause the appearance of hematuria and may result in a positive urine test for hematuria.

Menstruation can be ruled out as a cause of hematuria by looking at the menstrual history and ensuring that the urine sample is collected without menstrual blood.

The assessment of hematuria depends on the visibility of blood in the urine (ie, visible/gross vs microscopic hematuria).

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Hematuria alone without accompanying symptoms should raise the suspicion of urinary tract malignancy until proven otherwise.

Initial evaluation of patients with signs and symptoms consisting of hematuria includes assessment of hemodynamic status, underlying cause of hematuria, and safe urinary drainage. These steps include assessment of the patient’s heart rate, blood pressure, a medical examination by a health care professional, and blood tests to ensure that the patient’s hemodynamic status is adequate.

It is important to obtain a detailed patient history (ie, recreational, occupational, and medication exposures) as this information may be helpful in suggesting a cause of hematuria.

Physical examination may also be helpful in identifying a cause of hematuria, as certain signs found on physical examination may suggest specific causes of hematuria.

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In the event that the initial evaluation of the hematuria does not reveal an underlying cause, an evaluation by a doctor specializing in Urology can proceed. This medical evaluation may consist of, but is not limited to, a history and physical examination by health care personnel, laboratory studies (i.e., blood work), cystoscopy, and specialized imaging procedures (such as CT or MRI ).

The first step in evaluating red or brown urine is to confirm true hematuria with urinalysis and urinalysis, where hematuria is defined by three or more red blood cells per high-power field .

When gathering information, it is important to inquire about rectal trauma, urologic procedures, MSE, and culture-documented urinary tract infection.

If any of these are taken, a urinalysis with urinalysis should be repeated in 1 to 2 weeks or after treatment of the infection.

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If urinalysis and urinalysis results reveal a glomerular origin of the hematuria (indicated by proteinuria or red blood cells), a nephrologist should be consulted.

If urinalysis results indicate a non-glomerular origin, a microbiological culture of the urine should be obtained, if not already done.

If the culture is positive, treatment for the infection should be pursued, and urinalysis and urinalysis should be repeated after completion.

If the culture is negative or if hematuria persists after treatment, CT urogram and cystoscopy should be performed.

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It should be noted that hemodynamic stability should be monitored and a complete blood count should be ordered to evaluate for anemia.

In summary, those with visible hematuria confirmed by urinalysis and urinalysis and without rectal trauma, urologic procedures, MSE, or urinary tract infection should undergo cystoscopy and CT urogram.

This section needs to be updated. Please help update this article to reflect the correct facts or newly available information. (March 2023)

After detecting and confirming hematuria with urinalysis and urinalysis, the first step in the evaluation of microhematuria is to rule out major causes.

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Major causes include urinary tract infection, viral disease, kidney stones, rectal exercise, MS, rectal trauma, or rectal urological procedure.

After the underlying causes have been resolved or treated, a repeat urinalysis and urinalysis is warranted for safe cessation of hematuria.

If hematuria persists (and if a cause is suspected), the next step is to stratify the person’s risk of urothelial cancer into low, intermediate, or high risk to determine next steps.

To be in the low-risk category, all of the following criteria must be met: You have never smoked tobacco or smoked less than 10 pack-years; is a woman under 50 or a man under 40; has 3 to 10 red blood cells per high-power field; has not had microscopic hematuria before; and has no other risk factors for urothelial cancer.

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To be in the intermediate risk category, one of the following criteria must be met: He has smoked between 10 and 30 pack-years; is a woman aged 50 to 59 or a man aged 40 to 59; has 11–25 RBCs per high-power field; or was previously a low-risk patient with persistent microscopic hematuria and has between 3 and 25 RBCs per high-power field.

To be in the high-risk category, one of the following criteria must be met: Has smoked more than 30 pack-years; is over 60 years old; or has more than 25 RBCs per high-power field on any urinalysis.

For the low-risk category, the next step is to repeat a urinalysis with urinalysis in 6 months or perform a cystoscopy and ral ultrasound.

However, if no underlying cause is discovered, hematuria should be reevaluated with urinalysis and urinalysis within 12 months.

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In addition, for all risk categories, if a nephrological origin is suspected, a nephrologist should be consulted.

The pathophysiology of hematuria can often be explained by damage to the structures of the urinary system, including the kidney, ureter, bladder and urethra, and in m, the prostate.

Common mechanisms include structural disruption of the glomerular basement membrane and mechanical or chemical erosion of the mucosal surfaces of the urinary tract.

If this does not control bleeding, management should escalate to continuous bladder irrigation (CBI) via a three-port urethral catheter.

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If both a large Foley urethral catheter and a CBI fail, urgent cystoscopy in the operating room will be necessary.

Urosepsis is defined as sepsis caused by an infection of the urogenital tract and accounts for about 25% of all cases of sepsis.

Urosepsis is the result of a systemic inflammatory response to infection and can be identified by numerous signs and symptoms (eg, fever, hypothermia, tachycardia, and leukocytosis).

Signs and symptoms that indicate a urinary tract infection is the source of sepsis may include, but are not limited to, flank pain, costovertebral angle weakness, pain with urination, urinary withdrawal, and scrotal pain.

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In terms of visibility, hematuria may be visible to the naked eye (called “gross hematuria”) and may appear red or brown (sometimes referred to as tea-colored), or it may be microscopic (ie not visible to the eye, but detected from urosepsis.

In addition to imaging tests, sufferers can be treated with antibiotics to relieve infection and intravenous fluids to maintain cardiovascular and ral perfusion.

Acute management of hemodynamic status, if intravenous fluids are unsuccessful, may include the use of vasopressor medications and placement of a central line.

There are higher rates in individuals over 60 years of age and those with a history or history of smoking.

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When asymptomatic populations are screened with dipstick and/or microscopy medical tests, 2% to 3% of those with hematuria have a urologic malignancy.

These risk factors include age (>35 years), male smoking, previous or recent smoking, exposure to chemicals (eg, bzes or aromatic amines), and prior pelvic radiation therapy.

About 5% of people with microscopic hematuria are diagnosed with cancer. 40% of individuals with gross hematuria (readily visible blood in the urine) receive a diagnosis of cancer. Blood in the urine (hematuria) in children or pediatric hematuria is a condition that is often caused by kidney health problems. The kidneys filter the urine, making sure that there are no red blood cells (RBCs). However, in hematuria, the kidneys are not maintained

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