Conditions Treated

Hematuria

 

What is the definition of hematuria?

Commonly thought to be greater than 5 rbc’s per HPF on spun urine. A dipstick test will detect red blood cells but also will detect myoglobin and hemoglobin. After a positive dipstick, it is imperative to do a urine analysis. Other causes of dark urine include beets, blackberries, pyridium, rifampin, urate crystals, myoglobin and hemoglobin. Myoglobinuria may be seen after burns, crush injuries, myositis, and prolonged generalized seizures. Hemoglobinuria is most commonly associated with hemolytic anemias.

Common causes of hematuria in children

  • Urinary tract infection. Diagnosed by symptoms of burning and frequency and a positive urine culture on a properly collected specimen
  •  Familial benign hematuria- usually asymptomatic and may have minimal proteinuria. At times the hematuria may be gross.
  • Hypercalcuria- usually asymptomatic and may be microscopic or gross hematuria. Do a spot urine and measure the Ca/Creatinine ratio. Age related. 19 mo.-6 years is 0.42(95%)
  • Transient- no etiology established.
  • HSP- hematuria may precede the rash

How is blood in urine treated?

Treatments for hematuria vary widely and depend on the reason for the bleeding. It is important to note that quite often no cause is found for the hematuria. This should not be a source of major concern, however, since an appropriate workup effectively rules out the most serious causes of hematuria (for example, cancer). In cases where a workup is negative and the cause of the hematuria remains unknown, observation with repeat urinalyses is a reasonable option. A blood test to check kidney function and a blood-pressure check should be done as well. Caucasian men over 50 should discuss with their doctor an annual prostate-specific antigen (PSA) blood test which is used to screen for prostate cancer. Prostate screening in African Americans traditionally begins at age 45 and in all races, a history of prostate cancer in close family members may indicate an earlier start of screening.

Further discussion of the treatment for hematuria would depend upon the results of the workup and the exact cause for the hematuria. The urologist who performs this examination is responsible for recommending any further treatment or workup that would be necessary.

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