Hematuria is the presence of blood in the urine. This can be microscopically, without urine discoloration (chemically and microscopically diagnosed – more than 5-6 red cells per field, more than 5,000 red blood cells per minute), or macroscopic with red-brown urine, cloudy or clots in urine.
The origin of hematuria (blood in urine) can be intuited by the probe of the 3 sample cups that collect urine in the first, middle and final jet:
– If hematuria is initial is probably due to a diseases of the urethra;
– Hematuria at the end of the jet indicate a prostate or bladder origin;
– Presence of blood in the urine in all 3 cups indicate the origin as above the bladder (renal or extrarenal).
In all cases the presence of blood in urine should be differentiated from genital blood or urine changes due to medication.
The main causes of hematuria (blood in urine) are the kidney: glomerulonephritis, pyelonephritis, renal papillary necrosis, renal tuberculosis, polycystic kidney disease, renal tumors, renal infarction or renal trauma. Blood in the urine can also occur if the patient has bladder stones, urinary infections, urethritis, tumors of urothelial epithelium or prostate cancer or adenoma.
Extrarenal causes of hematuria (general causes) may be bleeding syndromes, overdose of coumarin medication, radiotherapy, systemic infections such as leptospirosis, or consumption of drugs such as cyclophosphamide or contraceptives.