RBCs in Urine or Hematuria: Causes, Symptoms, and Treatment

Blood in urine, or hematuria, is a serious medical condition and requires immediate treatment. Hematuria is divided into two forms: macroscopic hematuria, which can be seen with the naked eye, and microscopic hematuria, which can be seen with laboratory examination only. Hematuria is not a disease in itself, but a significant sign of an underlying process in the urinary system.

There are various causes of blood in urine. The most frequent causes are:

Urinary Tract Infections (UTIs): Urinary tract infection, which includes the bladder (cystitis) or the kidneys (pyelonephritis), is one of the most common causes of hematuria. These infections are followed by symptoms of burning during urination, frequent urination, and fever.

Kidney Stones: Hard mineral particles that form within the kidneys, ureters, or the bladder are one of the common causes of hematuria. When these stones pass through the urinary tract, they can cause inflammation and damage to the lining of the urinary tract and lead to blood in urine. Patients with kidney stones also complain of stabbing pain in the flank and pain.

Tumors of the Urinary System: Cancer of the kidney, ureters, or the bladder of the urinary system is a cause of hematuria. Although hematuria in early cancers is painless, its occurrence must always raise a suspicion of the necessity for medical investigation, especially in a patient with risk factors such as smoking or occupational exposure to chemicals.

Medical Kidney Diseases: Medical diseases such as glomerulonephritis, which is inflammation of the filtering units of the kidney (glomeruli), can be a cause of microscopic hematuria. It is often followed by hypertension, proteinuria (increased protein in urine), and swelling in the lower limbs.

Radiation-Induced Damage: A history of previous radiation therapy to the pelvic region, for instance, for cervical or rectal cancer, can cause hematuria. Inflammation and scarring of the bladder as a result of radiation (radiation cystitis) can cause bleeding in the urine.

Diagnosis of hematuria involves a complete medical history, physical examination, and diagnostic tests such as:

· Urinalysis: To detect red blood cells, protein, or infection.

· Imaging Studies: Ultrasound, CT scan, or MRI to detect kidney stones, tumors, or structural abnormalities.

· Cystoscopy: A procedure in which a thin, flexible tube is inserted into the bladder to examine the urinary tract for abnormalities.

· Infections: Bacterial infections are treated with antibiotics.

· Glomerulonephritis: Treated with medications such as immunosuppressants or corticosteroids, depending on the severity.

· Kidney Stones: Treatment ranges from pain management and hydration to non-surgical laser therapy or lithotripsy. In some instances, minimally invasive surgery may be required.

· Cancer Treatment: Tumors in the kidneys, bladder, or ureters are treated with a combination of surgery, chemotherapy, radiation, and advanced treatments such as laparoscopic or robotic-assisted surgery.

Hematuria should never be ignored. Whether the urine is visible with blood or microscopic blood, immediate medical care is required. A urologist is the ideal specialist to diagnose and treat hematuria, thus providing timely treatment and best outcomes.

Hematuria is a critical symptom that can be the harbinger of a myriad of underlying conditions ranging from benign infections to life-threatening malignancies. Early diagnosis and appropriate treatment can effectively cure the condition. Do you notice blood in your urine? Approach a healthcare provider without delay to determine the cause and get the right treatment.