Treatment of Hematuria

About the disease

Hematuria (the presence of blood in the urine) usually occurs when the kidneys, which are responsible for filtering waste out of the body, allow blood cells to leak into the urine. In 90% of cases, hematuria is caused by an infection of the urinary tract or kidneys and is usually not permanent, but goes away after the acute phase of infection passes. Urinary tract infections usually develop when infectious bacteria enter the body through the urethra as a result of sexual intercourse or poor hygiene.

One of the first symptoms is a frequent and strong urge to urinate, which can be accompanied by pain in the pelvic cavity. If an infection is not treated at once, hematuria can develop complications. Kidney infections, such as pyelonephritis, enter the kidneys through the blood. There are many possible ways that the blood stream could get infected, with causes ranging from an unhealthy lifestyle to a genetic predisposition. In some cases, hematuria is caused by kidney or bladder stones, which cause obstruction and bleeding. In men, hematuria can develop as a result of an enlarged prostate, which compresses the urethra and thus affects the blood flow. Certain medications can have such side effects as blood in the urine. If this happens, the patient should stop taking this medication. Weight-lifting and continuous exercise can create pressure on the bladder and lead to hematuria, although this is quite rare.

Symptoms

• Blood in the urine
• Painful urination
• Unusual blood clots
• Fever
• Burning sensation
• Pain in the bowel

Diagnosis

• During a physical examination, the doctor may examine a male patient’s prostate to see if it is enlarged, while a gynecologist will usually ask a female patient whether she has any problems concerning her menstrual cycle, which can also cause blood to appear in the urine. 
• Urinalysis can find out whether there is an excessive amount of red blood cells in the urine, which is a direct indicator of an infection.
• Ultrasound can find out whether there are stones in the bladder or kidneys.

Treatment

• Most commonly, conservative treatment will rid a patient of the symptoms of this condition. Doctors will usually prescribe antibiotics if the underlying cause of hematuria is an infection, because certain bacteria need to be blocked to stop the inflammation process.
• Shock wave therapy is commonly used to eradicate stones in the bladder or kidneys. It does this by breaking the stones down and making the minerals, which formed the stones, exit the body through the urethra. 

Authors: Dr. Nadezhda Ivanisova, Dr. Sergey Pashchenko