Blood during urination is detected by a visual sign - the color of urine. She has a dynamic from pale yellow, inherent in people who do not have such pathologies, to bright yellow with shades of red. If the red tint is saturated, then they talk about macrohematuria. Sometimes urine may be of a normal color, but red blood cells are found in it. In this case, they speak of microhematuria.
Classification of pathology
Blood during urination can have a different nature of origin.
Depending on at what point in time it appears during the act of urination, the following types of hematuria are distinguished:
- initial - is formed at the beginning of the process, the source is the affected initial section of the urethra;
- terminal - in this case, there is blood at the end of urination, the cause is urolithiasis, cystitis, damage to the internal urethra, prostate in men;
- total - blood is present in any portions of urine,sources may vary.
Depending on the clinical picture of the pathology, the following types are distinguished:
- painless;
- pain;
- recurrent;
- persistent.
The first of them is observed in diseases of the bladder, and in men - also in pathologies of the prostate. Urination pain and blood occur with uric acid crises, urolithiasis and cystitis.
Resistant variety observed in nephropathies. Recurrent may occur with glomerulonephritis.
The following types of hematuria are distinguished according to the mechanism of development:
- postrenal - formed against the background of pathological changes in the urinary tract and bladder;
- renal - its cause is kidney failure and other ailments of these organs;
- extrarenal - formed due to external factors.
View of blood when urinating
When visually observed in the urine, it can have various external manifestations, which also indicates the pathology that caused its appearance. The following types of blood are distinguished:
- "meat slop" - brown with impurities of blood clots;
- brown and dark brown colors indicate that urine with blood has stagnated in the bladder;
- scarlet urine indicates fresh bleeding;
- loose large blood clots that move with difficulty through the urethra enter it from the bladder;
- worm-shaped clots indicate that bleeding comes fromkidney.
Reasons for urinating with blood
Depending on the disease that provokes its appearance, they can be different. So, with hematuria of the prostate, the following may be the causes:
- prostatitis (rarely accompanied by bleeding);
- prostate cancer;
- prostate adenoma.
Blood when urinating may be linked to bladder problems:
- cancer of this organ - when blood is discharged from the urethra, the urine becomes rusty or dark red;
- cystitis usually occurs without bleeding, but sometimes there is such a discharge at the end of urination in women, which is a symptom of a hemorrhagic lesion of the bladder;
- stones in this organ, which constantly injure it, resulting in the release of blood of varying degrees of intensity.
The causes of blood when urinating in women during cystitis can also be the following:
- kidney injury;
- interstitial nephritis, in which blood in the urine appears as a result of various drug therapies;
- kidney cancer - in this case, the blood becomes like worm-like clots;
- stones;
- glomerulonephritis in acute and chronic forms - in this disease, blood in the urine is not detected visually, microscopic examination is necessary;
- infections that cause kidney tuberculosis, pyelonephritis.
The red color of blood may be due to the fact that a person consumes foods containing chemical dyes of a similar spectrum, such as beets.
Clinical manifestations of hematuria
There are no characteristic symptoms for her, since she herself is such in relation to other diseases. In this case, there may be pain during urination, an increase in body temperature, pain in the lower abdomen and lumbar region.
The main clinical manifestations of hematuria are as follows:
- accumulation of blood clots in the urinary tract that prevent free urination;
- epidermal color dynamics;
- there is a feeling of thirst, dizziness, general weakness;
- urine turns different shades of red;
- in the excreted urine, blood may be present in the form of clots;
- in some cases, painful syndromes and cramps are noted.
Diagnosis
It consists of conducting comprehensive research:
- cystoscopy - endoscopic examination of the internal structure of the bladder;
- intravenous pyelogram, which identifies problems with the urinary system;
- Ultrasound of the abdominal cavity, which allows to determine the condition of the ureters, bladder, kidneys;
- urography MR and CT to detect the condition of the latter and urinary tract;
- abdominal x-ray - rarely used.
With a viewFor diagnosis, microscopic analysis of urine can be used. In this case, both general and biochemical types of analyzes are carried out, as well as one according to Nichiporenko.
The three-glass test can be used to diagnose hematuria. In this case, urine is collected in three different containers, in which the presence of uniform elements is established. If they are present in the first sample, then this indicates a lesion of the urethra. In the presence of blood after urination in the second and third samples, prostate cancer or cervical cystitis can be suspected. If blood is present in all containers, this may indicate the development of tumor neoplasms in the prostate, kidneys or bladder.
Hematuria in the weaker sex
Mainly due to hemorrhagic cystitis, which develops while taking combined oral contraceptives or antibiotics. These drugs have a negative effect on the walls of the urinary tract. At the same time, the permeability of the vessels may be different, and therefore the development of both macro- and microhematuria is not excluded.
Injury to the bladder, its tumors can lead to blood loss, as well as the fact that due to heavy physical exertion there is a possibility of prolapse of the uterus, which leads to damage to the vessels of the ureters.
In addition, women have bleeding in the urine during menstruation, which is false hematuria.
Vaginitis can lead to blood in the urine, as well as cervical erosion. Also she canenter the urine during the postmenopausal period, due to changes in hormonal levels.
Hematuria in the stronger sex
Blood when urinating in men is mostly caused by benign growths. It can also be due to intense physical activity.
Also, hematuria may be due to the fact that various oncological diseases develop, and above all prostate cancer. Tumors grow into the walls of blood vessels, destroying them, which causes bleeding.
Blood in the urine during urination in a man may be due to urethrorrhagia, in which the penis remains intact, and blood oozes from the urethra, including with sperm.
In addition, it can appear due to chronic urethritis, in which the mucous membrane has a loose structure and constantly bleeds.
Erythrocytes in urine are observed as a result of the development of inflammatory processes in the genitourinary system. Also, in a man, the appearance of blood in the urine may be due to the fact that he has anemia, glomerular nephritis, urolithiasis, leukemia. Older men may experience prostate enlargement, which leads to compression of the urethra.
Exit of urine with blood can also be caused by sexually transmitted diseases.
Some of these pathologies cause blood to enter the urine at the beginning of urination (cancer, enlarged prostate, foreign body), and others at the end of this process (coagulation disorder, leukemia, anemia).
Hematuria in children
In childhood, this pathology is mainly caused not by diseases of the kidneys or urinary tract, but by blood ailments and hemorrhagic diathesis. Blood diseases cause damage to the blood vessels.
Children's urine can be saturated with blood and due to various viral infections. This is due to the fact that the virus infects the walls of blood vessels. In addition, a similar condition can be observed when taking NSAIDs.
Hematuria in pregnancy
Frequent urination of blood may occur in women who are expecting a baby. This may be due to the same forms of cystitis that are characteristic of other periods of development of the female body.
Besides this, the following processes are typical for pregnant women:
- increased late intra-abdominal pressure leading to bleeding of small renal veins;
- enlarged uterus affects urinary tract and kidneys;
- hormonal restructuring of the body's work occurs.
These symptoms of hematuria go away on their own after a woman gives birth.
During pregnancy, a woman's urethra may leak blood as the uterus grows in size and begins to put more pressure on the bladder.
Treatment
It is determined by the disease that caused blood to enter the urine. So, cystitis and urethritis are treated with antibiotics, diuretics and antispasmodics are used. Urolithiasis is treated by crushing stones or removing them surgically. When bladder tumors occur, they are diagnosed and an appropriate operation is performed. In case of injuries of the genitourinary organs, hemostatic drugs are used and they are sewn up. When the uterus is lowered, surgery is performed.
Prostatitis is treated with antibiotics, immunomodulators, painkillers and anti-inflammatory drugs. In addition, vitamin supplements and dietary complexes are prescribed.
In conclusion
Blood during urination can be in the urine for various reasons. To detect them, it is necessary to conduct a comprehensive examination. In people of different age groups and different genders, the causes may be different. At the same time, such of them as urolithiasis, pathological conditions of the kidneys, obstruction of the urethra are characteristic of all people. It is necessary to eat right, limit physical activity, identify urological problems in the early stages.
