Blood in the urine (hematuria) is alarming, but not necessarily serious and life threatening. Urine usually takes on a darker brown, amber color. At other times it can appear as bright red blood. Irregardless, prompt evaluation by a physician is important. The following is a list of common causes of hematuria with associated symptoms:
1)Urinary Tract Infection. This includes bladder, kidney and prostate. Usually there is fever, pain with urination, frequent urination, a sudden urge to urinate and groin pain (prostate) or unilateral back pain (kidney).
2)Kidney stone (see picture). Pain usually comes in waves, is severe, and radiates from the back around to the groin. If fever is present, the chance of a concurrent urinary tract infection is quite high. This can quickly lead to sepsis, or infection in the blood stream, and subsequent death.
3)Trauma. A bruised or lacerated kidney or lower urinary tract organ (ie: bladder). Usually there is a history of high impact trauma. Seek immediate medical care. Imaging studies such as CT scan are usually obtained.
4)Cancer. Bladder and kidney cancer frequently starts with bleeding. Much more common in smokers. Usually painless. Evaluation requires an imaging study and a scope.
5)Kidney inflammation. Many causes, from autoimmune conditions like lupus, to medications such as aspirin and ibuprofen, to post infectious causes like untreated strep throat. Sometimes a kidney biopsy is ordered.
The physician will need a urine sample to evaluate your cause of hematuria. He may also ask for blood work and an imaging study as discusseed above. Combining these studies with a thorough history and examination will help the physician arrive at the proper diagnosis and subsequent treatment…Richard R Samuel, MD Family Practice and Urgent Care
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