Idiopathic hematuria. Hematuria: common causes, common symptoms, modern treatment for blood in the urine

Blood in the urine during pregnancy (hematuria) appears quite often, how dangerous this symptom is, we can only speak after the examination. Most often, short-term minor hematuria in pregnant women is not dangerous, goes away on its own and does not require special treatment. But hematuria can also be a dangerous symptom.

Idiopathic hematuria of pregnancy

Idiopathic hematuria of pregnancy is the appearance of blood in the urine at any stage of pregnancy, which does not pose a serious danger. The causes and mechanism of development of this symptom are not exactly established. It is believed that on early dates Pregnancy hematuria is caused by a sharp change in hormonal levels. On the later dates it could be compression from the growing uterus Bladder, ureters and kidneys, which leads to circulatory disorders in this area. After childbirth, this symptom usually goes away on its own.

Despite the fact that idiopathic hematuria does not pose a threat to a pregnant woman, the appearance of blood in the urine should be the reason for the examination and the exclusion of serious causes of its appearance.

Infectious and inflammatory diseases of the kidneys and urinary tract

Blood in the urine during pregnancy may appear against the background of infectious and inflammatory diseases of the kidneys and urinary tract. There are even such diagnoses as pyelonephritis of pregnant women and cystitis of pregnant women. These diseases develop during pregnancy and disappear after childbirth.

The reasons for the development of infectious and inflammatory diseases of the kidneys and urinary tract have not been precisely studied, but it is believed that the main reason is a decrease in immunity associated with hormonal changes during pregnancy.

The main task of the body after conception is to maintain pregnancy. In order for the foreign cells of the growing fetus not to conflict with the mother's body, under the influence of hormones, her immunity decreases. Therefore, pregnant women are susceptible to any infectious diseases. They also often exacerbate chronic infectious and inflammatory processes that went unnoticed before pregnancy.

Urine with blood during pregnancy can appear, both with pyelonephritis and with cystitis. Pyelonephritis is characterized by the presence of small impurities of blood in the urine, which can be detected only with laboratory research. In addition, leukocytes and bacteria can be found in the urine.

AT different dates Pregnancy pyelonephritis proceeds in different ways. At the beginning of pregnancy, these are pronounced lower back pains, which at a later date lose their intensity. Sometimes the temperature may rise and be disturbed general state.

Acute pyelonephritis rarely has a significant effect on the course of pregnancy and childbirth. But with chronic pyelonephritis, miscarriage is possible , premature birth, development and toxicosis. In chronic pyelonephritis, it is also quite often necessary to resort to stimulation of labor during childbirth. Acute pyelonephritis of pregnant women usually disappears after childbirth, while chronic pyelonephritis remains and requires constant monitoring and treatment.

Blood in the urine of a pregnant woman can also appear with cystitis. Acute cystitis more common in women who have not previously suffered from this disease. It starts suddenly, usually after severe hypothermia. Symptoms of acute cystitis are pain in the lower abdomen and frequent painful urge to urinate, sometimes passing only a few drops of urine.

In severe cystitis, its course can take on a hemorrhagic character with the release of a few drops of blood at the very end of urination or even blood clots. Often, the temperature rises, general malaise, headache appear.

Pyelonephritis and cystitis of pregnant women require immediate medical attention, and sometimes hospitalization of the woman.

Preeclampsia

Urine with blood during pregnancy can be a sign of late pregnancy toxicosis - preeclampsia. This is the most dangerous reason hematuria. Preeclampsia first manifests itself in the form of hidden or obvious edema, and then a woman's high blood pressure (BP) rises, appears

Causes of hematuria underlie the understanding that hematuria is a symptom kidney and urinary tract diseases. Blood in the urine is more often found in laboratory tests; patients rarely self-complaint about its appearance.

With the naked eye, blood in the urine can be seen at a concentration of 5 ml per 1000 ml. It gives the urine the red color characteristic of bleeding only for the first few hours, then the urine turns brown. In this regard, this symptom cannot be reliably excluded only on the basis of patient complaints.

Urine may turn red when taking some medicines(phenindione, rifampicin) and food products (beets). With intravascular hemolysis, free hemoglobin appears in the urine, and with rhabdomyolysis, myoglobin is determined.

Schönlein-Henoch purpura

Pathological changes resemble manifestations of IgA nephropathy. In the urine, erythrocytes and urinary casts are also detected. Diagnosis usually allows suspecting skin and joint manifestations. In adults, renal pathology is more pronounced.

Benign familial hematuria

The disease manifests itself with recurrent episodes of hematuria against the background of preserved kidney function. Subsequently, persistent microhematuria occurs. Usually kidney function does not change. As a rule, there is a family history of the disease. Kidney biopsy, which is optional in the presence of a family history, reveals thin basement membranes without signs of inflammation.

Alport syndrome

Alport syndrome is a rarer variant of familial glomerular pathology, manifested by hematuria, glomerulonephritis, and bilateral sensorineural deafness. The disease is usually inherited in an X-linked dominant fashion. As a rule, the syndrome manifests itself with massive hematuria in the first years of life, followed by microhematuria and proteinuria. Kidney pathology often develops to deafness.

Schistosomiasis

Patients from Africa should be aware of the possibility of this disease, especially if hematuria occurs at the end of urination. In centrifuged urine, eggs of Schistosoma haematobium are found.

sickle cell anemia

Africans also have a higher prevalence of this disease, which is considered a risk factor for papillary necrosis. The screening analysis is positive if 30-50% of hemoglobin is represented by the HbS form during electrophoresis.

Diseases of the glomeruli of the kidneys

If erythrocyte or leukocyte casts are found in the urine in combination with altered erythrocytes, the probability of glomerular disease is extremely high.

The presence of protein once again confirms this assumption. Kidney dysfunction may occur. In some cases, if localization of the process in the glomeruli is suspected and in the absence of a clear family history, a kidney biopsy is required to make a diagnosis.

In the absence of casts and altered erythrocytes, cystoscopy and excretory urography with intravenous contrast are usually performed, but in patients of European descent younger than 40 years, the cause of hematuria is most often not found.

Tumors as causes of hematuria

In patients with hematuria older than 40 years, the risk of detecting a tumor is much higher. The most common is renal cell carcinoma, or hypernephroma. The tumor usually manifests with hematuria or groin pain. During the examination, it is sometimes possible to palpate the tumor. Systemic manifestations include fever, hypercalcemia, and erythrocytosis. The diagnosis is confirmed by ultrasound examination of the kidneys.

Transitional cell carcinoma can develop in the renal medulla, along the ureter, or in the bladder. Characteristic beginning clinical picture diseases with hematuria and pain syndrome, especially if the tumor obstructs the ureter. Bladder polyps often bleed. Prostate cancer can grow into the ureter and cause bleeding.

In each case, the bleeding is fresh blood with no erythrocyte casts or deformities and usually no significant proteinuria in the absence of massive bleeding. The examination plan should include ultrasound examination of the kidneys, cystoscopy, biopsy and, in some cases, intravenous urography.

Diagnosis of hematuria

The most important causes of hematuria are presented in the sidebar (below). When blood is found in the urine, it is necessary to establish its cause. Pain in the groin can be a symptom of a stone, infection, kidney or ureter tumor.

Urinary frequency and dysuria, urinary infections, difficulty urinating, urgency, and weak urine stream are often due to hypertrophy or prostate cancer. Passing blood-stained urine in the absence of other urinary symptoms is characteristic of kidney cancer, a tumor, or a bladder polyp. Constant use of analgesics sometimes causes papillary necrosis of the kidneys, which manifests as hematuria or colic, due to the passage of the papilla through the ureter.

An objective study rarely provides important information.

Raise blood pressure speaks in favor of primary renal pathology (for example, glomerulonephritis or pyelonephritis). Sometimes there are signs of a clotting disorder (bruising or purpura), an increase in the size of one or both kidneys, suspicious of a kidney tumor, or polycystic disease. For the infectious process, pain is typical on palpation of the bladder, prostate or kidney, depending on the location of the inflammation.

Further studies depend on the age of the patient and associated pathological signs, as well as the results of an extended urinalysis. It is advisable to build a diagnostic algorithm depending on the clinical picture. The figure shows the approach to the examination of a patient with hematuria.

Microscopy of urine

Conventional tests for the detection of blood in the urine are based on the reaction of hemoglobin with orthotoluidine. If the result is positive, urine is examined for the presence of red blood cells, which are absent in hemoglobinuria. Microscopy is performed in a sample of fresh urine, since when it is settled, erythrocyte lysis occurs. In addition, microscopy can detect erythrocyte and leukocyte casts, indicating kidney pathology.

An experienced microscopy specialist is able to give accurate information about the localization of the source of bleeding. When erythrocytes pass through the glomerulus, they take on a bizarre shape, while when bleeding from a tumor or inflammatory focus, erythrocytes are not changed.

With a positive urine test for hemoglobin, protein in the urine is not always detected, since during bleeding, blood may not be enough to get positive reaction. For positive result about 10 times more blood is needed than for a hemoglobin reaction (about 40-50 ml of blood per 1000 ml of urine). If the protein is found in slightly blood-stained urine, this indicates a lesion at the glomerular level.

Hematuria with accompanying symptoms

Pain and hematuria

Renal pain syndrome is characterized by dull pain in the lower back. It can be associated with hemorrhage into the tumor, stones or blood clot in the renal pelvis, bleeding into the cyst in polycystic and acute pyelonephritis.

For ureteral pain, colic is typical, combined with marked restlessness, nausea, and sweating. It is usually caused by a stone in the ureter and may be associated with bleeding. The blood clot itself can provoke colic, for example, with a kidney tumor or papillary necrosis.

A special diagnostic problem is presented by patients with recurrent episodes of renal pain in the lower back, combined with hematuria, the cause of which cannot be clinically identified. These are usually young women, sometimes with a history of urolithiasis; examination does not allow a definite diagnosis to be established. In some cases, there are indications of the abuse of strong analgesics in the anamnesis. Simulation of hematuria is possible, especially in patients with medical education.

The clinical picture tends to disappear with pain medication, but recur after many years.

Frequent urination and hematuria. Inflammatory diseases of the lower urinary tract cause increased urination and can lead to hematuria with a pronounced inflammatory process in the mucous membrane.

Acute infection often complicates an underlying bladder disease, such as a tumor, chronic TB infection, or schistosomiasis. Usually, the diagnosis is established on the basis of the results of urine culture, however, with severe bleeding or with the development of a similar clinical picture in a man, cystoscopy is indicated.

Asymptomatic hematuria

In young people with asymptomatic hematuria, it is very often not possible to identify the cause of relapses of isolated hematuria. The presence of erythrocyte cylinders and erythrocytes with altered morphology is characteristic of glomerular lesions. The three most common types of glomerular lesions are:

1. IgA nephropathy,
2. Schönlein-Henoch purpura,
3. benign familial hematuria.
4. IgA nephropathy.

This disease is usually detected in men aged 20-30 years; in history, patients note episodes of pharyngitis and myalgia, after which over the next 24 hours there is an obvious hematuria that lasts 2-6 days. The disease is characterized by relapses, sometimes patients are diagnosed arterial hypertension and impaired renal function. Altered erythrocytes, erythrocyte and leukocyte cylinders are found in the urine. Attacks pass independently, but there is a tendency to recurrence.

Over time, there may be a slow decline in kidney function, although in a small proportion of patients kidney failure develops very quickly. The cause of the disease is unknown, but it is believed that the damage is due to the deposition of IgA immune complexes. Dense deposits of IgA are found in the mesangial space. Segmental damage to the glomeruli occurs, and proliferative changes are often found, including the formation of crescents.

Hematuria is a condition in which erythrocytes (red blood cells) appear in the urine. It can occur with various renal and extrarenal pathologies. It occurs in both children and adults. For diagnosis, laboratory and instrumental methods are used.

What is hematuria and what causes it

Hematuria is said to be when red blood cells are found in a person's urine. They can be seen with the naked eye or only under a microscope. This is not an independent disease, but a symptom that accompanies various diseases.

Hematuria develops due to many reasons:

• inflammatory processes caused by bacteria, viruses, fungi;
• injury to any part of the genitourinary system;
• toxic effects - chemical substances, drugs;
• urolithiasis;
• blood pathologies;
• autoimmune diseases;
• anomalies in the development of the genitourinary system;
• benign and malignant tumors;
• heart disease;
• medical manipulations.

Fine healthy man excretes up to a million red blood cells per day in the urine.

If the erythrocytes are visible to the naked eye, then they talk about macrohematuria, if only under a microscope - microhematuria

Several factors predispose to the occurrence of hematuria:

• physical activity that increases blood pressure abdominal cavity and small pelvis - weight lifting, sexual intercourse, sports activities;
• medical procedures - staging urinary catheter, endoscopy, biopsy, blood transfusion;
• hypothermia;
• some types surgical operations, including gynecological;
• acute conditions of the body - myocardial infarction, poisoning, allergic shock.

Hematuria occurs more frequently in adults than in children.

Table: distribution of causes of hematuria by age categories

Kinds

There are many types of hematuria. The classification is based on the features and causes of occurrence, the manifestation of the state.

Table: classification of hematuria

Associated symptoms

Hematuria itself is a symptom. It may be accompanied by other signs of the disease that caused it:

• pain in the genital area, perineum, lower back;
• nausea and vomiting;
• dizziness, loss of consciousness;
• pale skin, cold sweat;
• severe weakness, fever;
• frequent urge or difficulty urinating.

In some cases, other symptoms, except for the appearance of blood in the urine, are not observed. This condition is characteristic of hereditary familial hematuria.

Hematuria is often accompanied by pain in the kidney area.

Diagnostic methods

The first stage of diagnosis is the collection of patient complaints and the dynamics of the state to determine possible cause appearance of blood in the urine:

• the presence of chronic diseases;
• injuries of the kidneys and perineum;
• taking medications;
• Lifestyle;
• heredity.

After the interview, a physical examination of the person is carried out. The doctor probes the area of ​​the kidneys, the abdomen. The temperature is measured, the symptom of concussion of the lumbar region is evaluated.

Hematuria is diagnosed in an average of 12% of the population.

To identify the disease that caused hematuria, instrumental and laboratory examination methods are required.

Video about the diagnosis of hematuria - urologist Natalya Lavrentyeva

Table: examination of a patient with hematuria

The kidneys must be examined to determine the cause of blood in the urine.

Differential Diagnosis

Differential diagnosis is carried out between different types hematuria and is based on causative factor and features of the appearance of blood in the urine.

1. Urolithiasis causes the appearance of blood in the urine due to injury to the mucosa. The amount of blood depends on the extent of the injury.
2. Tumor of the kidney. Blood in the urine occurs due to damage to blood vessels. The presence of clots is characteristic.
3. Glomerulonephritis. Erythrocytes enter the tubules of the kidneys from the capillaries. Associated with proteinuria.
4. drug intoxication. Hematuria is due to toxic effects on the vessels.
5. Anomalies in the development of the urinary tract. Blood flows into the ureters due to high blood pressure in them. It is recurrent in nature, that is, it disappears and reappears, accompanied by pain in the lower back.

To distinguish between hematuria according to the source of bleeding, a three-glass test is performed, in which it is determined in which portion of the urine blood appears.

To conduct a three-glass test, a person is given three jars, and he urinates alternately into each of them. So get three servings of urine - from the urethra, from the bladder and from the kidneys.

Methods of treatment

Once the diagnosis is established, hematuria is treated with stationary conditions. Therapeutic tactics is determined by the doctor depending on the causative disease.

Important! In some cases, treatment must be carried out urgently - with acute bleeding from any part of the urinary system.

Planned therapy is carried out by conservative and surgical methods.

Medical

The purpose of drugtherapy to stop bleeding. For this, drugs from the group of hemostatics are used. After the elimination of the acute condition, the causative disease is treated - with antibacterial agents, herbal anti-inflammatory drugs, antispasmodics.

With severe bleeding, infusion therapy is carried out - with a solution of sodium chloride, glucose, polyglucin. In chronic hematuria, iron preparations are prescribed to restore red blood cells and hemoglobin.

Table: drugs to eliminate hematuria

Photo gallery: drugs used in the treatment of hematuria

Kanefron - herbal uroseptic Dicynon - a means to stop bleeding
Tavanic is a broad-spectrum antibiotic Ketorol - pain reliever No-shpa - antispasmodic

Folk remedies

Treatment of hematuria folk remedies unacceptable. Use of hemostatic herbal preparations perhaps only briefly, before going to the doctor.

1. Water pepper tincture. Prepare at the rate of 30 drops per 1/2 cup of water. The drug is contraindicated in people with increased blood clotting. It is forbidden to take tincture for more than three days without consulting a doctor.
2. Decoction of nettle leaves. Dry raw materials (2 tablespoons) are poured with a glass of water and brought to a boil. After that, cool and drink half a glass 2 times a day.
3. Decoction of hemorrhage. A spoonful of raw materials is poured into a glass of water and boiled for 10 minutes. Filter and take in a warm form, half a glass 2 times a day.

Long-term use of herbal remedies is agreed with the doctor.

Surgical intervention

In some diseases, accompanied by the appearance of blood in the urine, surgery is indicated, in particular with:

• acute renal colic with intractable pain syndrome;
• purulent lesions of the kidney - apostematous nephritis, abscess;
• foreign body of the urinary tract;
• injury to the kidney and urinary tract.

With renal colic, the stone is removed laparoscopically. A laparoscope is used for this. Online access represents two or three small holes in the anterior abdominal wall, through which the doctor removes the stone under the control of a video sensor. The same operation is performed in the presence of a foreign body.

With renal colic, laparoscopic stone removal is indicated.

In case of kidney injury, a full laparotomy approach is required. At the same time, a cut is made abdominal wall, stop bleeding, eliminate visible damage. Then the abdominal cavity is washed with an antiseptic solution and the wound is sutured, leaving drainage. Purulent diseases also require open operation, removal of pus and drainage of the kidney.

Physiotherapy

With renal colic, thermal procedures are shown - UHF, heating pads on the lumbar region. P In inflammatory diseases, physiotherapy is used only after the elimination of the acute process. Appoint:

• magnetotherapy;
• electrophoresis;
• galvanic currents.

These techniques contribute to the improvement of microcirculation, the final cessation inflammatory process. Thus, the formation of adhesions is prevented. Physiotherapy is prescribed in a course - usually 10-15 sessions are performed.

Diet

A specific diet for hematuria is not required. The doctor recommends to exclude from the diet:

• alcohol;
• fatty food;
• smoked meats;
• spices.

Preferred dairy and vegetable food with the addition of boiled or steamed meat. The diet should contain a sufficient amount of protein, vitamins, iron. Daily it is recommended to consume fresh vegetables and fruits, herbs.

Features of the treatment of pregnant women and children

Treatment in pregnant women and children is carried out according to the same principles as in other people. The difference lies in the dosages of the drugs.

Dosages of drugs for children are calculated by body weight.

Also, almost all antibiotics used in the treatment of inflammatory kidney diseases are contraindicated for pregnant women - Ceftriaxone, Tavanic, Ciprofloxacin. The only drug allowed is Vilprafen.

Prognosis and complications

The prognosis of hematuria depends on the causative disease. More dangerous is prolonged macrohematuria, leading to large blood loss. This contributes to the development of severe anemia. Complications are also due to the underlying disease.

Prevention

There is no specific prophylaxis for hematuria. Patients with risk factors need to regularly examine the urinary system. It is recommended to avoid injury and hypothermia.

Hematuria is often manifested in formidable diseases of the kidneys and genitourinary system. Blood that has entered the urine gives it a characteristic color, ranging from dark brown to bright red, depending on the amount of blood or red blood cells, as well as the level and site of bleeding. But often there are cases where the urine changes color due to a violation of the diet or eating foods rich in coloring pigments. For example, beets, blackberries, rhubarb, or many synthetic vitamins and medications. Manufacturers warn about this in the instructions, but if there is no such warning, and the color of urine has noticeably changed, then you should be wary. It is better to do an analysis and consult a doctor in order to avoid complications.

Hematuria may be visible to the naked eye (gross hematuria) and is easily identified by the patient. And there may be hidden hematuria (microhematuria), which is detected using a general urine test. Normally, there are no erythrocytes in the urine or no more than 1-5 in the field of view. Sometimes urine may be unstained, have a normal color, but still contain blood clots.

Sometimes women may be misdiagnosed with hematuria(when hit menstrual blood into a urine collection container). To avoid this, it is better to refuse the appointment of an analysis during menstruation. But if such an analysis is still necessary, a woman should make a thorough toilet of the genital organs and, directly when collecting urine, close the entrance to the vagina with a gauze napkin. This will make the analysis as informative as possible.

The reasons

There are many reasons for the development of hematuria:

• inflammation;
• bacterial lesions of the urinary tract;
• diseases of the hematopoietic organs and blood;
• transfusion of incompatible blood by group;
• congenital anomalies or malformations;
• tumors;
• infection of the kidneys;
• necrosis of the kidney or its area;
• trauma;
• violations by of cardio-vascular system(thrombosis, embolism, aneurysm);
• poisoning and acute intoxication;
• the use of certain drugs (anticoagulants).

Classification

During the act of urination, several types of hematuria are distinguished:

• initial when blood clots or slight diffuse inclusions are present in the first portion of urine.
• Final, if blood appears at the end of urination, in the last part of the urine.
• Total, when there is blood in the entire amount of urine.

it important point, which should not be omitted when making a diagnosis.

Depending on the etiology given symptom, there are several types of hematuria:

• extrarenal occurs in conditions not related to the functioning of the kidneys and urinary tract (in diseases of the blood and blood-forming organs);
• renal, when the functionality of the kidney is impaired (with kidney disease, pyelo- or when the renal glomeruli are affected);
• postrenal, i.e. disorders below the level of the kidneys (with damage to the urinary tract, for example, urolithiasis, tumors, injuries).

Symptoms

Symptoms given state depends on the reasons for it. Hematuria is often accompanied by pain rarely appears asymptomatically. May be accompanied by fever, weakness, pallor skin, dizziness and loss of consciousness.

The manifestation of symptoms depends on the severity of the condition and the amount of bleeding. Among the main symptoms should be highlighted:

• the presence of visible clots and impurities of blood in the urine;
• pain and cramps when urinating;
• pain in the kidneys and lumbar, in one or both sides (may be constant or cramping);
• thinning of the urine stream or intermittent urination (due to blockage of the urethra by a blood clot);
• weakness, dizziness, dry mouth and thirst, pallor (indicates heavy bleeding).

It should be noted that hematuria often occurs in women in the last stages of pregnancy due to compression of adjacent organs by an enlarged uterus. This condition can be dangerous for the expectant mother, and you need to be very careful about this symptom. Do not confuse excretion of blood with urine and bloody issues from the genital tract. These are two completely different conditions, but they require immediate medical attention, otherwise there may not be a very favorable outcome for both the woman and her child.

Diagnostics

The diagnosis is based on identifying the causes of hematuria, diagnosing the underlying disease. Often, hematuria is detected by visual examination of the urine, but this is not enough.

To make the correct diagnosis, use:

• general urine analysis;
• urinalysis according to Nechiporenko;
• cystoscopy;
• urography;
• examination by related specialists (gynecologist, proctologist).

An important role is played by the collection of anamnesis, a detailed questioning of the patient about the previous condition, the presence of injuries, operations or other diseases.

An indicative method for diagnosing hematuria is three-glass sample. Urine is collected in portions, in three separate containers. Then examine each portion separately. The presence of blood and clots in the first portion indicates mechanical damage and trauma to the urethra. This can happen due to incorrect manipulations or medical procedures(setting a urinary catheter, cystoscopy), domestic injuries or violent sexual intercourse.

Impurities in the next two servings indicate damage to the bladder, injuries to the kidneys and urinary tract, or their various diseases.

Often, small blood clots can be observed in the urine due to urolithiasis. When stones move along the ureter or in the bladder itself, the walls can be injured, and blood appears. This phenomenon can be periodic or occur after vigorous physical exertion.

The presence of blood in all portions may be a sign serious illnesses kidney and the genitourinary system, such as tumors, kidney cancer, prostate cancer in men, the genitourinary system as a whole and individual sites or organs, kidney injury.

Treatment

The elimination of hematuria is directly related to the treatment of the disease that caused this symptom, and depends on the nature of this disease.

In severe condition and severe pain for initial care patient is given pain medication. Hemostatic drugs are not used until the cause of hematuria is established, which may prevent a correct diagnosis.

It is allowed to put an ice pack on the bladder area. After diagnosis - urgent introduction of coagulants.

It is worth noting that many drugs have a cumulative effect, and their action can occur after a few hours, therefore, in a hospital with traumatic hematuria and severe bleeding, doctors often use a method such as infusion of a cool solution of aminocaproic acid directly into the bladder by catheterization if the nature of the injury allows. With abundant blood loss, intravenous infusions are prescribed.

Treatment methods for diseases that cause hematuria can be different:

• Emergency or planned surgery is indicated for injuries, tumors.
• Prescribing antibiotics for infectious inflammation.
• Elimination of stones in urolithiasis, the introduction of antispasmodics and procedures that facilitate the movement of stones and their discharge.
• The appointment of corticosteroids, if in addition to hematuria, there is also.
• Appointment of B vitamins and iron preparations.

Some conditions do not require specific treatment, but it is enough to comply with strict bed rest, rules healthy eating and personal hygiene.

Possible

With untimely access to a doctor, hematuria is dangerous:

• worsening condition;
• the development of intoxication of the body;
• blockage of the urinary tract with blood clots;
• the development of anemia;
• growing pain syndrome.

Prevention

There is no specific prevention of hematuria, because. it is not a disease, but a symptom. Has the meaning avoid hypothermia, viral infections , observe personal hygiene to prevent inflammation and damage to the kidneys and urinary tract.

Forecast

Since hematuria is not an independent disease, its cure is directly depends on treatment with which it is associated. Timely diagnosis hematuria reveals dangerous diseases kidneys and start adequate therapy on time.

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If during laboratory tests hematuria was detected with the presence of blood inclusions in the urine, this is an alarming signal, which means that a person needs to see a doctor to identify the pathology and treat it. What are the main reasons that blood appears in the urine test, what diagnostic measures will help determine the root cause of the pathology, and what treatment will help prevent the development of complications?

General information

The norm is 1−2. When blood is detected in the urine test, the color of the urine acquires a reddish tint and varies depending on the severity of hematuria. There are such types of hematuria as micro- and macrohematuria:

1. Microhematuria shows a slight presence of blood (2-3 erythrocytes in the field of view), while it is not always possible to determine the pathology with the naked eye. Micro particles of blood can only be seen with the help of laboratory tests.
2. Macrohematuria, which is divided into initial, total and terminal degree of hematuria. If the urine test for hematuria is positive, you should immediately consult a doctor for advice.

Causes of pathology

The causes of hematuria are different, from mechanical damage to the organs of urination and kidneys to the presence of malignant tumor. Common causes of hematuria are:

• infectious lesions of the urinary system and kidneys;
• cancer of the bladder, kidneys;
• mechanical damage;
• the presence of conglomerates;
• congenital problems with the organs of urination;
• imbalance in the blood;
• vascular problems;
• complications in diabetes mellitus;
• urolithiasis disease;
• reaction to blood in the urine is positive after kidney surgery.

Infectious lesion

With urinary tract infections, you can often see traces of blood in the urine. At the same time, the patient also has other symptoms: burning during urination, frequent urge to go to the toilet, a small volume of urine during urge, fever. These are characteristic symptoms for cystitis, urethritis, pyelonephritis. With inflammation, when kidney hematuria develops, in urine tests, in addition to blood inclusions, particles of pus and mucus can be detected. If you do not start treatment of the disease, kidney failure develops, which is life-threatening.

Hematuria after trauma

It also appears in cases of injury to the abdominal organs. With severe injuries in the process of urination, a person feels severe pain, if during palpation pain increase, then the bladder may have ruptured. At severe pain in the region of the transverse section, there is a suspicion of kidney damage. If the perineum is damaged, the woman's external genitalia should be examined. If you are worried about pain pubis, while the general condition worsens, this may mean that a rupture of the urea has occurred.

With urolithiasis

If crystals of stones form in the kidneys or urea, this is also the reason that in the analysis of urine, blood appears as multiple inclusions. Neoplasms gradually increase in size, injuring the walls of the tissues of the organ, which leads to the development chronic inflammation, infectious complications and characteristic symptoms. Often a person does not even suspect that he has such a disease, but when the analysis indicates a positive indication of blood in the urine, treatment should be started.

blood clots

If micro blood clots are visible in the composition of urine with hematuria, there is a high probability that cancer of the urea or kidneys develops in the body. Urinary cancer is a fairly common ailment, so if such a symptom occurs, you should urgently go to the hospital. Urinary affects cancer of three varieties. Transitional cell is the most common, affects the tissues of the organ and arises from the cells of the transitional epithelium. With adenocarcinoma, the glandular cell ceases to function normally, while pathology is rare. Squamous cell carcinoma also diagnosed infrequently, the disease develops when there is a malfunction in the cells of the squamous epithelium.

In addition to the presence of blood in the urine, there are other symptoms of bladder cancer.

If oncology was detected on early stages, then the disease is successfully treated by surgical removal of the affected area. With metastasis and complete damage to the bladder, its complete removal is indicated.

Pathology in women

If in general analysis urine, a woman has occult blood, it is necessary to conduct a more detailed examination and identify the source. More often, this is a complicated development of an infectious lesion of the urination organs, in which the work of the bladder, ureters and kidneys worsens. In the initial stages, total hematuria occurs, in which occult blood can only be detected by laboratory testing. If the disease is not treated and the signs are ignored, terminal hematuria develops, in which blood is excreted in the urine in the form of drops. The appearance of blood in the urine is a reason for parents to take tests and go to the doctor.

The main reason for this pathology is glomerulonephritis. Other reasons include congenital anomalies, bladder and kidney infections, trauma to the child's external genitalia, and poor hygiene. If urine appears in the urine of the crumbs, while the child behaves uncharacteristically, this means that a dangerous inflammatory disease which requires urgent detection and treatment. There is also benign hematuria, which is inherited and is not dangerous. Blood tests should be taken regularly and the results monitored.