Download Hematuria - Chesterfield Urology

6055 harbour park drive
midlothian, va. 23112
chesterfield
urology
web:
e-mail:
phone: 804.639.7777
fax:
804.739.1021
www.chesterfieldurology.com
[email protected]
Hematuria – Blood in the Urine
Blood is not normally seen in the urine either with the naked eye (gross hematuria) or with a
microscope (microscopic hematuria).
Causes may include:
Infection
Stones
Prostate
Problems
Bladder Cancer
Kidney Cancer
Cancer of the
Ureter
Physical Activity/Trauma
Abnormal Blood Vessels
Determining the source of the blood and developing a treatment strategy is generally the
same for both gross (visible) and microscopic hematuria. Trying to define the source of
bleeding requires evaluating the entire urinary tract and checking for infection and/or
malignant cells in the urine. For this reason, several tests may be required:
 Urine Culture – A sample of urine is sent to the laboratory and any bacteria are grown
and identified. This also includes a testing of antibiotics to determine which
medications will best treat the infection. Patients who are treated with antibiotics may
be changed to a different antibiotic if this testing shows another medication would be
more effective.
 Urine Cytology – A sample of urine is sent to the laboratory and cells that have fallen
off of the bladder lining are evaluated under a microscope. If the cells appear
cancerous, further evaluation will be required. This generally would mean a biopsy.
 X-ray Evaluation of Kidneys and Ureters – Generally one of two tests:
o CT scan – gives a detailed image of the kidneys and ureters but is costly and
involves x-ray exposure
o Ultrasound – less expensive and avoids x-ray exposure, but does not provide as
good of an image of the kidneys and generally doesn’t show the ureters.
 Cystoscopy – looking in the bladder with a scope. A procedure done in the office and
generally well tolerated. Please see “Cystoscopy”.
Outcomes:
 Many times these studies will not show any obvious reason for the bleeding.
 However, when problems are found they are generally found early and are able to be
treated easily. Diagnosis and treatment options will be discussed with you by your
urologist.
 If the problem is very small, it is possible the initial studies may miss it – further
evaluation may be needed if the bleeding persists or returns.