CONSULTANT
CONSULTANT
Jewel Urology Center, Mumbai
Nanavati Hospital, Mumbai
Saifee Hospital, Mumbai
DR. VIVEK VENKAT
Compassionate Evidence-Based Ethical Cancer Care
docvivek@gmail.com
HEMATURIA (BLOOD IN URINE)
- Hematuria is the presence of blood in the urine.
- This may be seen by the patient themselves (gross hematuria) or be detected on testing of the urine (microscopic hematuria).
- It may be painless or associated with burning in the urine or kidney pain.
- Patients may also notice the passage of clots in the urine which may sometimes obstruct urine passage.
WHAT ARE THE COMMON CAUSES OF BLOOD IN THE URINE?
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Hematuria must never be ignored. While the vast majority of cases are due to benign causes
up to 3% of microscopic hematuria and 10% of gross hematuria can be due to urologic cancers.
- Urologic Cancers – Bladder cancer is the most common cancer causing blood in the urine. Cancers of the ureter, kidney and prostate can also cause hematuria. Risk factors are age >50 years, male sex, smoking, exposure to chemicals, history of radiation, painkiller use and family history.
- Urinary tract infection – Cystitis (bladder infection) or pyelonephritis (kidney infection) can cause blood in the urine.
- Kidney, ureter or bladder stones
- Prostate enlargement – This is a common cause in elderly men.
- Kidney diseases – Diseases like glomerulonephritis can cause hematuria. These are the commonest causes of blood in urine among children.
- Kidney or bladder trauma.
- Medications – Blood thinners can be associated with blood in urine.
- Strenuous exercise like long distance running can cause hematuria.
- Sometimes despite a thorough evaluation no direct cause may be found.
Common causes include:
WHAT ARE THE TESTS TO DIAGNOSE BLOOD IN THE URINE?
- Urine analysis and urine culture – The routine urine analysis will help to detect any infection, kidney disease or the presence and quantity of blood cells in the urine. The urine culture will help to isolate the infection causing bacteria and let the doctor know which antibiotic will work against it.
- Urine cytology – This detects the presence of abnormal or malignant cells in the urine.
- Imaging studies – The ideal recommendation is to perform a CT Urography scan in all patients to look at the kidneys, ureter and bladder for any tumors or stones. A good quality Ultrasonography study may be done initially as well.
- Cystoscopy
- PSA – This is a blood test to assess prostate health. Men over 50 years may have blood in the urine due to benign enlargement of the prostate or prostate cancer and should be investigated.
Blood in the urine should never be ignored and always needs investigation. The tests commonly needed are:
Treatment for the hematuria will then depend on its cause.
WHAT IS A CYSTOSCOPY ? HOW DO I PREPARE FOR IT?
-
At your first visit you would have discussed in detail your symptoms, other medical information
and medications you take with the urologist.
- What are the possible causes for the blood in my urine?
- What additional tests may be needed?.
- What are the implications of my pre-existing medical conditions and medications?
- Is this likely to recur?
- What treatment may I need?
Once the reports of your urine tests and imaging studies are available you may discuss the following issues with your doctor:
-
Depending on your test results and individual risk factors, the doctor may recommend a cystoscopy.
- Basic blood and urine tests
- Possible need to stop blood thinning medication l for 5-7 days
- Treat any urine infection if present
A cystoscopy is like a gastroscopy (where a camera is inserted to look at the stomach).
In a cystoscopy the urologist inserts an endoscope with a camera through the urinary passage to look at the bladder and prostate.
Some bladder tumors may not be seen on the CT scan and a cystoscopy is the best way to diagnose them and other causes.
To proceed with cystoscopy the general instructions are:
WHAT TO EXPECT DURING AND AFTER CYSTOSCOPY?
- A cystoscopy is an outpatient or daycare procedure and does not require admission.
- You will be lying down on the operating table with your legs raised.
- You will receive a short anesthesia or sometimes only local anesthesia.
- The doctor will insert an endoscope via the urine passage to look in your bladder.
- The entire procedure lasts less than 10 minutes and you should be back home in a couple of hours.
- Depending on the findings of the procedure the doctor will explain any further treatment.
- There are no complications as such, however there may be a little burning or blood in the urine for a day or two.
FAQs
What are the causes of hematuria?
Blood in the urine is usually due to benign causes like infections or stones, however it is very important to rule out urologic cancers which are seen in up to 10% cases.
Can blood in the urine recur?
Depending on the cause there is a possibility of recurrence.
Does every patient with blood in the urine need a cystoscopy?
Ideally all patients need a cystoscopy. However the urologist may recommend it on a case-to-case basis depending on the results of the other tests and your risk factors.
Is a cystoscopy painful?
The procedure can cause some discomfort in men especially due to their longer urethra and may need a short anesthesia. After the procedure there is usually no pain.
CONTACT US
Location 1:
Jewel Urology Center
No. 89, N. S. Road Number 1,
Navpada, JVPD Scheme,
Andheri West
Mumbai 400049, India
(m):+919136041545
Visiting Hours : Mon-Sat 4.30 - 6 pm
By appointments only
Email: appointments@drvivekvenkat.com
Phone:+919136041545
Whatsapp: +919136041545
Jewel Urology Center
No. 89, N. S. Road Number 1,
Navpada, JVPD Scheme,
Andheri West
Mumbai 400049, India
(m):+919136041545
Visiting Hours : Mon-Sat 4.30 - 6 pm
By appointments only
Email: appointments@drvivekvenkat.com
Phone:+919136041545
Whatsapp: +919136041545
Location 2:
Nanavati Max Hospital
S.V road, Vile Parle west
Mumbai 400056, India
Visiting Hours : Mon-Sat 2 - 4.30 pm
Email: appointments@drvivekvenkat.com
Phone:+919136041545
Whatsapp: +919136041545
Nanavati Max Hospital
S.V road, Vile Parle west
Mumbai 400056, India
Visiting Hours : Mon-Sat 2 - 4.30 pm
Email: appointments@drvivekvenkat.com
Phone:+919136041545
Whatsapp: +919136041545
Location 3:
Saifee Hospital
15/17, Maharshi Karve Rd,
Opposite Charni Road Station East,
Mumbai 400004, India
(m):+919136041545
Visiting Hours : Thursday 11am - 1 pm
By appointments only
Email: appointments@drvivekvenkat.com
Phone:+919136041545
Whatsapp: +919136041545
Saifee Hospital
15/17, Maharshi Karve Rd,
Opposite Charni Road Station East,
Mumbai 400004, India
(m):+919136041545
Visiting Hours : Thursday 11am - 1 pm
By appointments only
Email: appointments@drvivekvenkat.com
Phone:+919136041545
Whatsapp: +919136041545
