Blood in Urine: Dosage, Symptoms, Causes and Treatment

Haematuria is the medical term used to describe the presence of blood in urine. It can be visible to the naked eye or detected only by laboratory tests. In this article, we will explore the possible causes, symptoms, diagnosis, and available treatment for hematuria.



◉ Types of hematuria

Hematuria can be classified according to its presentation, its origin and according to the chronology of the appearance of blood in the urine:

1. Classification according to presentation

  • Gross Hematuria: Occurs when the amount of blood in your urine is large enough to be seen with the naked eye. In this case, the urine may take on a pink, bright red, brownish tint or have visible blood stains. Haematuria can be visible from as little as 1 ml of blood per liter of urine. It always requires an etiological investigation.
  • Microscopic hematuria: Occurs when the amount of blood in your urine is so small that it cannot be detected with the naked eye. However, through urine tests or observation under a microscope, the presence of red blood cells in the urine can be identified.
  • 2. Classification according to origin

    3. Classification according to chronology

    ◉ What causes blood in urine?

    ◉ The presence of blood in the urine can be caused by a variety of etiologies, found along the entire genitourinary tract. This includes the kidneys, ureters, bladder, prostate (in men) and urethra.

    ◉ Bleeding disorders can cause blood vessels to become fragile, making it easier to bleed into different parts of the urinary system. Among these disorders:

    ◉ Blood may appear to be in the urine when it is actually coming from other sources, such as:

    ◉ The presence of red urine does not always mean that there are red blood cells in the urine. There are several other possible causes that can give urine a red tint:

    ◉ Diagnosis

    It is important to see a doctor for a proper diagnosis and evaluation. The diagnosis of hematuria usually involves the following steps:

    Anamnesis

    The doctor will use the information gathered during the history to help formulate an accurate diagnosis:

    Physical examination

    A physical examination may be performed to assess general health and look for any signs or symptoms that may suggest the cause of hematuria.

    Urine analysis

    There are several methods to detect the presence of blood in urine, including:

    1- Urine dipstick test

    The urine dipstick test is one of the most common methods used to detect the presence of blood in urine.

    The test is read by comparing the color of the test strip to a color chart provided by the manufacturer.

    blood in urine by urine dipstick

    2- Microscopic analysis

    Microscopic analysis can detect red blood cells in urine and assess their morphology (isomorphic or dysmorphic), which can provide additional information on the origin of hematuria.

    A red blood cell is usually a pale yellow disc-shaped cell, 6 to 8 μm in diameter and with a dimple in the center. Its morphology varies depending on urine properties such as osmotic pressure and pH as well as the site of bleeding.

    Urinary red blood cells under microscope

    Urinary red blood cells under microscope

    3- Automatic urine analyzer

    Automated detection of blood in urine can be performed using specialized laboratory instruments. These instruments use different techniques to detect and quantify the presence of blood objectively and accurately.

    Additional tests

    Depending on the results of the urinalysis and other symptoms presented by the patient, additional investigations such as blood tests, ultrasounds, CT scans, cystoscopies or kidney biopsy may be recommended.

    ◉ Treatment

    Once the cause of the blood in your urine has been identified, your doctor will begin treatment for that specific condition. They will then reassess you to determine if the blood is gone. If blood is still present in your urine, further tests may be needed or you may be referred to a specialist such as a urologist or nephrologist.

    There are several treatment options for hematuria: