What does blood in the urine, hematuria mean? (invisible, in pregnancy, in children)

Blood in the urine, blood-tinged urine, bleeding from the urethra or also hematuria. These terms are linked by the presence of erythrocytes (red blood cells) in the urine.

In some cases, in addition to urinating blood or blood-coloured urine, other urological or general disorders are associated. It is then necessary to assume a disease.

However, there is not always a disease behind the presence of blood in the urine.

The cause of isolated hematuria may not be found. It happens in children, babies, young, adults, men, women and the elderly.

Isolated hematuria = blood in the urine without other health problems.

The literature states that in most cases it is a benign (harmless, benign, not serious) problem. Blood stained urine can occur in up to 4% of healthy children without a known cause.

Haematuria can therefore be a symptom of a disease, but it can also be a condition that is unrelated to the disease. It also depends on whether it occurs on its own, as a one-off, or whether it is associated with other problems and persists, recurring over a long period of time.

Examples of opposites are:
Blood in the urine caused by excessive physical exertion or stress.
x
Blood in the urine caused by malignant or cancerous disease of the excretory system.

The presence of blood in the urine may be detected incidentally during another examination when it is not outwardly visible. A tiny presence of red blood cells in the urine cannot stain it.

On the other hand, there is hematuria, which is visible to the naked eye. And in this case, the coloration of the urine may vary. Several factors affect the color and shade.

Plus...

Red urine also occurs after consuming certain foods, food dyes, liquids or medications.

What is behind the blood in the urine and what is it a sign of?
How is hematuria differentiated?
What other symptoms are associated with it?
For more interesting information, read the article...

What does hematuria mean and how is it differentiated?

Hematuria means the presence of blood in the urine. It is assessed based on several characteristics and parameters.

The first important division is by whether or not it is visible to the naked eye.

Classification of hematuria by intensity - quantitative assessment:

• macroscopic hematuria - visible to the naked eye, also referred to as "large"
  • 1 ml of blood per litre of urine - produces a visible change in urine colour
• microscopic haematuria - not visible externally, can only be detected by examination
  • fewer or 3 erythrocytes per field of view, in 2 out of 3 urine samples
  • 5 erythrocytes in children
  • on microscopic examination

Less than 2 erythrocytes per field of view is considered the norm.

In microscopic haematuria, there are too few red blood cells in the urine and therefore too little red blood pigment. They cannot colour the urine. However, they can be detected with a urine test paper or by microscopic examination of the urine.

In contrast to the macroscopic form. In this, the value is already exceeded and the blood colours the urine red or a different shade and colour. Using the colour of the urine, possible causes can then be predicted.

Plus...

Microscopic hematuria often takes place asymptomatically, i.e. asymptomatically. The cause of this condition is, for example, excessive, excessive, too long-lasting physical exertion.

It is also referred to as post-exercise marching haemoglobinuria.

Haemoglobin + uria = red blood pigment in the urine.

But...

If hematuria is accompanied by other symptoms such as dysuria, abdominal pain, pelvic pain, pain radiating to the back, sacrum and kidney area, or elevated body temperature, a professional examination should be sought immediately.

Dysuria = difficulty urinating/pain when urinating.

Colour of urine and possible cause:

• Red - beetroot, blueberries and similar fruits, food dyes, lead or mercury poisoning, drugs, urinary tract infection, porphyria, wine, muscle inflammation, burns
• pink - foods such as beetroot and blood in urine, porphyria, muscle inflammation, burns, wine
• brown - bile dyes in urine, liver and gallbladder disease, aloe vera, rhubarb, bacteria in urine, beans, antimalarials
• brown-black - alkaptonuria (rare autoimmune disease), malignant melanoma
• dark yellow to orange - dehydration, carrots, vitamin C, fever, sweating, antibiotics

In conjunction with urine color, whether the urine is discolored at the beginning, at the end of urination, or throughout. From this perspective, it is possible to predict the location of the problem.

Initial hematuria at the beginning of urination = problem in the urethra.

Terminal hematuria at the end of urination = problem in the kidneys or ureter, but also in the bladder, prostate.

Haematuria throughout urination = trigone of bladder, lower and upper urinary tract, prostate, bladder.

Further...

Is hematuria transient or permanent?

It can be transient in young people as well as in children. The reason for this is exercise, an accident or fever, but also, for example, a disease, inflammation of the urinary tract (uroinfection).

It is permanent when it persists.

The next step is to evaluate the origin of bloody urine.

The table shows the distribution of haematuria according to origin

The causes can be different

As indicated in the table, the causes can be varied. Red discoloration of the urine without blood is present when certain foods and food dyes (beetroot, blackcurrant) are consumed. At that time, no examination is needed.

However, dark-coloured urine can be the result of several diseases. It also occurs in jaundice, which is the result of a liver disorder. In this case, the urine is dark to the colour of a kofola.

Alternatively, it is the effect of drugs, antibiotics (penicillin), aspirin, heparin or warfarin (and other drugs affecting blood clotting), chemotherapy or radiotherapy.

Mostly in diseases of the urinary tract.

Urolithiasis is most common in young people, and in women or men between the ages of 15 and 40.

Kidney and urinary stones are formed from insoluble minerals, substances that form tiny crystals. These irritate and damage the mucous membrane as they pass through the urinary tract, causing bleeding.

Reduced fluid intake and dehydration also contribute to stone formation. Urine is thick and does not adequately dissolve substances that would not normally clump together.

A urinary stone can be the cause of obstruction (blockage) of the ureter or bladder. In addition, uncomfortable pain occurs when the stone travels. It is also referred to as renal or kidney colic.

Blood itself can also cause blockage of the urinary tract, in the form of a blood clot.

In people after the age of 60, inflammation is often the underlying cause. However, at this time of life, it is also necessary to think about malignancy.

Macroscopic hematuria from age 40 to 60 = risk of malignancy.
In men over 60, up to 25% due to cancer.
In women, inflammation and cancer are common after 60.

With microscopic hematuria, the incidence of cancer is less than 1%.

10-50% of cases are represented by idiopathic hematuria. It is a form in which the cause of blood in the urine is not detected.

Read also:

• Urinary tract inflammation is particularly troublesome in summer for the fairer sex
• Blood in the urine. You wouldn't expect it as a symptom of these diseases

No pain, but not without problems. For men, women and children.

Not always the diseases are accompanied by pain in the kidney area. Kidney damage can manifest itself in frequent urination, swelling, which is very often and in the beginning especially around the eyes, or blood pressure increases.

On the other hand, there are difficulties that directly alert a person that there is a disease of this system.

An example is pain on urination, which may be cutting, scratching, pinching, burning or itching. Urination is frequent, with a small amount of urine and painful.

Alternatively, in infectious diseases, there may be discharge from the urethra. An example is gonorrhoea.

How gonorrhoea is transmitted
What is the risk of changing sexual partners,
Sexual diseases in summer, danger of sex tourism

Similarly with bacterial diseases. These can originate in the urinary tract. Women are particularly susceptible to urinary infections, uroinfections. A shorter urethra is also a predisposition.

Inflammation of the urethra and bladder is more common in women.
Repeated inflammation leads to a chronic problem.
Kidney failure is a risk.

With these inflammations there is a risk of spreading upwards, through the bladder and ureters to the kidneys.

Rarely, poststreptococcal glomerulonephritis can occur in children. This is an example of the spread of microbes from the blood to the kidneys.

In childhood, blood in the urine can also occur from an unknown cause.

The male population has a prostate problem.

The prostate is located at the base of the bladder. It is affected by inflammation and cancer, which can be severe and malignant. The benign form is benign enlargement of the prostate.

How to detect prostate cancer as early as possible and what are the treatment options?

Blood in the urine after intercourse?

Blood in the urine after sex is present in a small proportion in young women who have begun to have an active sexual life or in women who have a varied sex life. Predisposition is again due to a shorter urethra and frequent inflammation, changes in menstrual bleeding or hormonal changes.

Also referred to as honeymoon disease.

Adequate fluid intake, urination after sex, gentler sex, use of barrier devices and lubricants are preventive. Of course, disciplined partnered sex life.

Injuries can also occur if intercourse is not gentle and hard.

Care should be taken especially during pregnancy

Pregnancy is a period that is characterized by changes throughout a woman's entire organism. Moreover, during this period, a woman is more susceptible to various health problems.

There is an increased risk in pregnancy:

• urinary and kidney stones
• urinary tract and bladder inflammation, usually due to bacterial origin
• recurrent inflammation is a risk of kidney inflammation
• kidney inflammation is a risk for kidney failure

In addition, the risk of developing pre-eclampsia, eclampsia and HELLP syndrome. In these cases, in addition to blood, there is protein in the urine.

Protein and blood in the urine also occur together in urinary tract infections.

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Blood in the urine can occur in women before and after menstruation without a morbid basis.

Diagnosis and treatment of haematuria

The history, i.e. the description of the difficulties given by the sufferer, is important. In addition to the present problems, information from the family history, such as hereditary diseases, metabolic disorders, is also important.

The doctor asks about infections, excessive thirst, urination, medications taken.

A standard physical examination, blood and urine collection for laboratory evaluation are performed.

In the case of blood in the urine, two methods are available:

• diagnostic test strips
  • we can also perform a home test, but in some cases
  • it is evaluated according to the amount of blood per 1 to 4 crosses (depending on the manufacturer) and the amount of haemoglobin
  • can be a false positive
  • the tests also include other parameters such as pH, glucose, ketones, urobilinogen, bilirubin
• urinary sediment testing

Subsequently, imaging methods such as:

• USG ultrasonography - sonography of the kidneys and abdomen
• CT
• MRI
• intravenous urography IUV
• retrograde pyelography
• angiography

Cytoscopy and urine cytology may also complement.

The diagnosis and its conclusion is the basis of treatment. Antibiotics are administered when inflammation is present. When treatment with blood clotting drugs, these drugs are discontinued or adjusted to a different dosage or switched to low molecular weight heparin.

What helps with blood in the urine, you ask?

Herbal treatment can be given as an alternative to specialist treatment, an example being urological tea.

Of course, prevention from inflammatory or sexually transmitted diseases is important.

When is it necessary to see a doctor?

The causes of hematuria can be both benign and serious.

However, it is better to seek a professional examination. And especially in the case of associations of other health problems.

Symptoms that may be present along with hematuria:

• general malaise, fatigue, listlessness
• abdominal and lower abdominal pain
• pain in the flank and kidney area
• radiating pain into the back and lower back
• difficulty urinating and pain when urinating
• frequent urination or cessation of urination
• fever, chills
• paleness and sweating
• vomiting, feeling like vomiting
• pain and bleeding during sexual intercourse
• vaginal discharge and discharge from the penis

In children, the only symptom may be fever. In the case of the elderly, it is again changes in mental status.

+ some terms in context:

• hematuria - blood in the urine
• isolated haematuria - blood in the urine without other symptoms
• haematuria with bacteriuria - both blood and bacteria in the urine, detected on examination
• pyuria - pus in the urine
• urethroragia - bleeding from the urethra even without urination
• pneumaturia - foamy urine with bubbles at the end of urination
• sedimenturia - large amounts of crystals in the urine
• polyuria - increase in urine volume in 24 hours - over 2500 ml of urine
• oliguria - reduced urine volume in 24 hours - less than 400 ml of urine
• anuria - cessation of urine production by the kidneys or urine does not drain from the kidneys, empty bladder, less than 100 ml of urine
• urinary retention - is the cessation of urination due to an obstruction in the urinary tract