Blood in the Urine (Hematuria)

Blood in urine.jpg

The presence of blood in the urine may be accompanied by pain during urination or it could also be painless. A painless hematuria may be caused by various health conditions such as cancers.

Blood in the Urine

The presence of blood in the urine, may it be microscopic (meaning you cannot see it without a microscope) or gross (meaning you can see that your urine is not yellow, but rather pink or red).

When you come in to Fairbanks Urology, you first provide us with a urine sample that we test for infection as well as for blood in the urine. Using an automated urinalysis machine we can tell if you have any blood cells in the urine which could be concerning. 

The blood may come from the kidneys or the collecting system. Normally, a urine test is recommended by a physician to further examine the nature of the underlying condition that caused blood in the urine.

Urinalysis machine.jpg

The common causes of blood in the urine are urinary tract infections (UTI), urinary tract stones, benign prostatic hypertrophy (BPH), bladder tumors, urethritis, and prostate cancer.

Cancers, as we all know, are serious medical conditions. Various organs in the body can be affected by cancer. Cancer affecting the urinary system can result to a presence of blood in the urine. The signs and symptoms of cancer may not be seen or experienced during the early stages of the illness. When a visible blood in the urine is seen, it may be a sign of an advanced kidney, prostate, or bladder cancer.

Cancers that cause blood in the urine

Prostate Cancer

Prostate cancer is a type of cancer that affects the male’s prostate gland. The prostate gland is a small, walnut-shaped organ responsible for producing seminal fluid that nurtures and transports sperm.

This type of cancer is the most common cancer in men. Cancer typically grows slowly in size and remains in the prostate gland initially. Symptoms may not be present during the early stages. Common symptoms include difficulty in urinating, blood in the urine, reduced force in the urine stream, erectile dysfunction, and bone pain. Prostate cancer that’s detected during its early course has a better chance of survival and success of treatment.

Bladder Cancer

The bladder is a balloon-shaped organ located in the pelvis, with the main function of storing the urine. Bladder cancer, as the name implies, affects the bladder. Cancer in this organ starts in the cells lining the inside of the bladder. Bladder cancer may develop at any age, but it is most common in older adults.

Signs and symptoms of bladder cancer are blood in the urine (visible or microscopic), painful and frequent urination, and pelvic or back pain.

Kidney Cancer

Kidney cancer is the form of cancer originating in the kidneys. The kidneys are bean-shaped organs located behind the organs of the abdomen. The most common type of kidney cancer in adults is renal cell carcinoma, while Wilms' tumor is more common in children.

It is very rare that kidney cancer produces signs and symptoms during its early stages. Signs and symptoms during the later stages include blood in the urine, weight loss, back pain that doesn’t go away, intermittent fever, and fatigue.

Urethral Cancer

Urethral cancer is the rarest type of all urological cancers. It affects the urethra, a hollow tube that lets the urine pass from the bladder. This type of cancer is more common in men than women.

 

Evaluation of the urinary tract has 2 important components: CT & Cystoscopy

CT scan: 

The initial evaluation for AMH should include a radiologic evaluation. Multi-phasic computed tomography (CT) urography (without and with IV contrast), including sufficient phases to evaluate the renal parenchyma to rule out a renal mass and an excretory phase to evaluate the urothelium of the upper tracts, is the imaging procedure of choice because it has the highest sensitivity and specificity for imaging the upper tracts (Ref: AUA Guidelines, 2012 Recommendation)

Read more about CT scans for cancer detection here

Example of how hematuria workup lead to completing a multiphasic computed tomography urography in a 53-year-old man with hematuria secondary to a transitional cell carcinoma of the left ureter shows thickened, enhancing ureteric wall (arrow) with periureteric fat stranding (arrow) suggestive of a urothelial lesion with extramural spread of the disease. (C)Proximal hydronephrosis with hydroureter (arrow) is noted.

Example of how hematuria workup lead to completing a multiphasic computed tomography urography in a 53-year-old man with hematuria secondary to a transitional cell carcinoma of the left ureter shows thickened, enhancing ureteric wall (arrow) with periureteric fat stranding (arrow) suggestive of a urothelial lesion with extramural spread of the disease. (C)Proximal hydronephrosis with hydroureter (arrow) is noted.

Cystoscopy: 

A cystoscopy should be performed on all AMH patients who present with risk factors for urinary tract malignancies (e.g., history of irritative voiding symptoms, current or past tobacco use, chemical exposures) regardless of age. (Ref: AUA Guidelines, 2012 Recommendation)

Read more about cystoscopy here

Screenshot 2018-04-28 10.07.37.png

Bladder tumor seen on cystoscopy done for the presence of microhematuria


Do you have blood in your urine?

BOOK AN APPOINTMENT ONLINE 

oR CALL 907-328-0989 tODAY!

 Related: