Overview

Hematuria is the medical term for blood in the urine. It can be seen with the naked eye (gross hematuria) or only under a microscope (microscopic hematuria). Blood in the urine can come from any part of the urinary tract, such as the kidneys, ureters, bladder, or urethra. Hematuria is not a disease in and of itself; it is a sign that something else is wrong. Some causes are minor and only last a short time, but others can lead to serious problems such as infection, kidney disease, or tumors. Early evaluation is important for identifying what is wrong and ensuring the right treatment is given.

Symptoms
In gross hematuria, the urine may appear pink, red, or cola-coloured. Microscopic hematuria may not be visible to the naked eye and is often detected during routine tests. Symptoms that go along with it depend on the cause and can be pain when urinating, back or flank pain, frequent urination, fever, or stomach pain. In severe cases, blood clots may be present in the urine.

Causes
Hematuria can result from urinary tract infections, nephrolithiasis, trauma, intense physical activity, or prostatic hypertrophy. Blood can also leak from the body due to kidney diseases such as glomerulonephritis and inherited disorders. Tumors of the urinary tract may be less often to blame. Some medicines and blood-clotting problems further increase the risk.

Diagnosis
The first step in diagnosing is to test the urine for blood. Blood tests check how well the kidneys are working and look for infections. Ultrasound or CT scans are examples of imaging tests that can help find structural problems. In some situations, cystoscopy is performed to directly visualize the bladder.

Treatment
The main goal of treatment is to fix the root problem. Antibiotics are given to treat infections. In cases of kidney stones, pain-relief medicines are given, or surgery is performed to remove them. It's important to treat kidney disease or prostate problems. If tumors are found, specialized oncological care is needed. Regular monitoring ensures the problem is fixed and doesn't recur.

The prognosis depends on the aetiology. When the problem is caused by an infection or stones, proper treatment can often fix it. Early evaluation is essential, as hematuria may indicate a severe condition requiring immediate medical intervention.