Blood when urinating 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 shade is saturated, then they talk about macrohematuria. Sometimes the urine may be the usual color, but red blood cells are found in it. In this case, they speak of microhematuria.
Pathology classification
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, blood is noted at the end of urination, the reason is urolithiasis, cystitis, damage to the internal urethra, prostate in men;
- total - blood is present in any portions of urine, sources can be different.
Depending on the clinical picture of the pathology, the following types are distinguished:
- painless;
- painful;
- recurrent;
- persistent.
The first of them is noted with diseases of the bladder, and in men - also with pathologies of the prostate. Pain during urination and blood occur during uric acid crises, urolithiasis and cystitis.
A persistent variety is observed with nephropathy. Relapsing can occur with glomerulonephritis.
The following types of hematuria are distinguished by the development mechanism:
- postrenal - formed against the background of pathological changes in the urinary tract and bladder;
- renal - its cause is renal failure and other ailments of these organs;
- extrarenal - is formed due to external factors.
Type of blood when urinating
When visually observing it 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 slops" - brown with the presence of impurities of blood clots;
- brown and dark brown colors indicate that urine with blood stagnated in the bladder;
- scarlet urine indicates that fresh bleeding has opened;
- friable large blood clots, which move with difficulty along the urethra, enter it from the bladder;
- worm-shaped clots suggest that bleeding comes from the kidneys.
Causes of urination 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 blood secretion);
- prostate cancer;
- BPH.
Blood during urination may be associated with ailments of the bladder:
- cancer of this organ - in this case, blood is secreted from the urethra, the urine acquires a rusty color or becomes dark red;
- cystitis usually proceeds without blood secretion, but sometimes there is such a discharge at the end of urination in women, which is a symptom of hemorrhagic damage to the bladder;
- stones in this organ that constantly injure him, as a result of which blood of various degrees of intensity is released.
The causes of blood during urination in women during cystitis can also be the following:
- renal injury;
- interstitial nephritis, in which blood in the urine appears as a result of various drug therapy;
- kidney cancer - in this case, the blood becomes like worm-shaped clots;
- stones
- glomerulonephritis in acute and chronic forms - with this disease, blood in the urine is not detected by visual means, microscopic studies are necessary;
- infections causing kidney tuberculosis, pyelonephritis.
The red color of the blood may be due to the fact that a person consumes products containing chemical dyes of a similar spectrum, for example, 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, pain during urination, an increase in body temperature, pain in the lower abdomen and lumbar region can be noted.
The main clinical manifestations of hematuria are as follows:
- the accumulation of blood clots in the urinary tract, which do not allow the free exercise of urination;
- epidermal color dynamics;
- there is a feeling of thirst, dizziness, general weakness;
- urine is painted in various shades of red;
- in excreted urine, blood may be present in the form of clots;
- in some cases, painful syndromes and pains are noted.
Diagnostics
It consists in conducting comprehensive research:
- cystoscopy - an endoscopic examination of the internal structure of the bladder;
- intravenous pyelogram, with the help of which problems with the urinary system are identified;
- Ultrasound of the abdominal cavity, which allows to determine the condition of the ureters, bladder, kidneys;
- urography of MR and CT to detect the state of the last and urinary tract;
- abdominal radiograph - this method is rarely used.
For the purpose of diagnosis, a microscopic analysis of urine can be used. In this case, both general and biochemical types of analyzes are carried out, as well as such according to Nichiporenko.
For the diagnosis of hematuria, a three-glass test can be used. In this case, urine is collected in three different containers, in which the presence of shaped elements is established. If they are present in the first test, then this indicates a lesion of the urethra. If there is 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, kidney, or bladder.
Weak hematuria
It is mainly caused by hemorrhagic cystitis, which develops with the use of combined oral contraceptives or antibiotics. These drugs have a negative effect on the walls of the urinary tract. In this case, vascular permeability can be different, and therefore the development of both macro- and microhematuria is not excluded.
Injury to the bladder, its tumor, as well as the fact that due to great physical exertion there is the possibility of prolapse of the uterus, which leads to damage to the vessels of the ureters, can lead to blood loss.
In addition, women have blood discharge with urine during menstruation, which is false hematuria.
Vaginitis, as well as cervical erosion, can cause blood in the urine. It can also get into urine during the postmenopausal period, due to a change in hormonal levels.
Hematuria in the stronger sex
Blood when urinating in men is mainly caused by benign formations. It can also be due to intense physical exertion.
Also, hematuria may be due to the fact that various oncological diseases develop, and especially prostate cancer. Tumors grow into the walls of blood vessels, destroying them, which causes bleeding.
Blood in the urine during urination in a man can be caused by a urethrorrhagia disease, in which the penis remains intact, and blood oozes from the urethra, including sperm.
In addition, it can appear due to chronic urethritis, in which the mucous membrane has a loose structure and constantly bleeds.
Red blood cells in urine are noted 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, and bleeding. In older men, overgrowth of the prostate can be observed, which leads to compression of the urethra.
The output of urine with blood can also be caused by sexually transmitted diseases.
Some of these pathologies cause blood to enter urine at the beginning of urination (cancer, an enlarged prostate, a foreign body), and others at the end of this process (coagulation disorder, bleeding, 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 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 pregnant women
Frequent urination with blood can occur in women awaiting the birth of a baby. This may be due to the same forms of cystitis that are characteristic of other periods of the development of the female body.
In addition, the following processes are characteristic of pregnant women:
- increased intra-abdominal pressure in the later stages, which leads to hemorrhage of small renal veins;
- an enlarged uterus affects the urinary tract and kidneys;
- hormonal restructuring of the body.
These hematuria symptoms go away on their own after the woman gives birth.
During pregnancy, a woman may release blood from the urethra, since the uterus increases in size and begins to put more pressure on the bladder.
Treatment
It is determined by the ailment 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 surgically removed. If bladder tumors occur, they are diagnosed and an appropriate operation is performed. With injuries to the genitourinary organs, hemostatic drugs are used and they are sutured. With the omission of the uterus, surgery is performed.
Prostatitis is treated with antibiotics, immunomodulators, painkillers and anti-inflammatory drugs. In addition, vitamin supplements and dietary complexes are prescribed.
Finally
Blood during urination can be in urine for various reasons. To detect them, a comprehensive examination is necessary. In people of different age groups and different sexes, the reasons may be different. Moreover, such ones as urolithiasis, pathological conditions of the kidneys, urethral obstruction are characteristic of all people. It is necessary to eat right, to limit physical activity, to identify urological problems in the early stages.