The term medical hematuria is used to describe blood in the urine that occurs due to bleeding into the urinary system.
The urine usually appears red and rarely blood clots are seen.
Sometimes the bleeding can be at the microscopic level and the urine may seem normal.
In these cases, the blood can be detected only by laboratory analysis.


Classification of hematuria

  • Visible hematuria (also called macroscopic hematuria) occurs when blood is seen with the naked eye.
  • Non-visible hematuria (also called microscopic hematuria) occurs when there are traces of blood that can be seen only with microscopic analysis.

Symptomatic non-visible hematuria: associated symptoms are related to the lower urinary tract: hesitation, urgency, frequency, and dysuria.

Hematuria not visible without symptoms: it is observed in case of accidental or accidental analysis.

Although seeing blood in the urine can be scary, most of the time hematuria is not life-threatening and causes no symptoms.
However, it is important to study the cause of hematuria because it can be a serious disease.

Blurred urine can be caused by the presence of leukocytes, that is, white blood cells normally found in the blood.
When leukocytes reach the urine it means that there is an infection in the urinary system.


Causes of blood in the urine

In hematuria, the kidneys or other parts of the urinary system shed blood cells in the urine.

Several diseases can cause blood loss including:

Urinary Tract Infections Urinary
tract infections (such as cystitis ) can occur when bacteria enter the body through the urethra and begin to multiply in the bladder.
This disorder should be suspected in pregnant women  because it is quite common and also in newborns or infants.
Symptoms include a persistent urge to urinate, pain and burning during urination,and an extremely strong urine smell .
For some people, especially the elderly, the only sign of the disease are microscopic blood traces.

infections Kidney infections ( pyelonephritis ) can occur when bacteria enter the kidneys into the bloodstream or up from the ureters and into the kidneys.
Signs and symptoms are often similar to bladder infections, although kidney infections are more likely to cause fever and pain on the right or left side of the abdomen .

Kidney or bladder stones
Minerals in the concentrated urine sometimes precipitate forming crystals on the walls of the bladder or kidneys.
Over time, crystals can become small, hard stones.
The kidney stones are usually painless and probably the person does not know that has not cause an obstruction of urine flow or do not go.
There are usually no errors in recognizing the symptoms.
Kidney stones, in particular, can cause excruciating pain.
Stones in the kidneys or bladder can cause visible or microscopic bleeding.

Prostate enlargement
The prostate is located just below the bladder and surrounds the upper part of the urethra; often begins to grow when men come close to 50 years.
When the gland increases in volume it compresses the urethra, partially blocking the flow of urine.
Signs and symptoms of an enlarged prostate (benign prostatic hyperplasia) include difficulty urinating, persistent or urgent need to urinate, and blood in the urine, visible or microscopic.
Prostate infection ( prostatitis ) can cause signs and symptoms in males.

Kidney Diseases
Microscopic urinary bleeding is the most common symptom of glomerulonephritisthat causes inflammation of the kidney filtration system.
Glomerulonephritis may be the consequence of a systemic disease such as diabetes, or it may occur on its own.
This disease can be triggered by viral or bacterial infections (eg Streptococcus), blood vessel diseases ( vasculitis ), and immune problems such as IgA nephropathy or Berger’s disease, which affects the small capillaries that filter the blood in the kidney ( glomeruli ).

Blood visible in the urine can be a sign of advanced prostate , kidney or  bladder cancer . Unfortunately, there are no signs or symptoms in the early stages when these tumors are still curable.

Hereditary Disorders 
Sickle cell disease – an inherited hemoglobin defect in red blood cells may be the cause of blood in the urine, both microscopic and visible hematuria.
Alport syndrome affects the filtration membranes in the glomeruli of the kidneys.

Kidney damage
A trauma or other kidney injury caused by an accident or a contact sport can cause blood in the urine visible.

Some medicines can cause hematuria, for example, aspirin, penicillin, anticoagulants such as heparin and cyclophosphamide (Endoxan Baxter), which is an anticancer medication.

Intense physical activity
It is not clear why exercise causes visible hematuria. It can be bladder trauma, dehydration or rupture of red blood cells that occurs with prolonged aerobic exercise.
Runners are more affected, although almost all athletes can develop visible blood in the urine after intense training.

The catheter in the bladder
The catheter can injure the walls of the bladder when it is inserted or during movement of the body because it  scratches the inside. It should be  inserted with care by trained personnel.


What are the symptoms associated with blood in the urine?

Some patients are completely asymptomatic, especially if the blood is only detectable with a microscopic analysis of the urine.

Some associated symptoms can be:

Symptoms associated with infection:

More severe kidney infection:

Symptoms associated with prostate enlargement :

  • Frequent urination, also of small amounts of urine, because the prostate presses against the bladder. The urge to urinate frequently also appears at night,
  • Urgency to urinate,
  • Difficulty initiating urination,
  • Drip at the end of urination,
  • Reduced urine flow.

Dizziness or dizziness , especially when getting up from a sitting position.

  • Pale color.
  • Fast heartbeat .
  • Urinary retention (inability to urinate): If blood clots form in the bladder, bladder emptying can be blocked and the patient will have trouble urinating.



Diagnosis of blood in the urine

There are several tests available to determine the cause of hematuria. Most people do not need all of them.

  • Urine tests , the urine testsmay give clues to the cause of hematuria.

This includes a urine cytology that uses a microscope to analyze the inner wall cells of the bladder and kidneys (found in the urine).
Women should avoid urinalysis during menstruation because the result may be affected.

  • Blood tests , the blood testscan be used to look for signs of kidney problems or other illnesses that can cause hematuria.
  • computed tomography (CT) is a radiological examination examining the structure of the kidneys, ureters and bladder. Kidney stones or abnormalities in the kidneys, ureters, and bladder can usually be seen with a CT scan.
    Generally, a dye is injected into the vein during the exam to highlight all possible abnormalities.
  • Ultrasound of the kidneys, a kidney ultrasound  is an alternative to computed tomography and is convenient for people who are allergic to the contrast medium used on CT. Ultrasonography uses sound waves to create an image of the kidneys’ structure.
  • cystoscopy is a procedure that is performed to examine the bladder wall to determine if there is any abnormality.
    The examination is done as a surgical procedure on the hospital day.
    A small tube with a camera is inserted into the bladder through the urethra. Before inserting the tube, to reduce the discomfort an anesthetic gel is applied.
    Most patients tolerate this procedure very well.
    If the doctor detects the presence of abnormal tissue, a biopsy may be performed.
    The material collected by the biopsy is examined under a microscope to determine whether abnormal or cancerous cells are present.
  • Biopsy of the kidneys, during a biopsy, the doctor removes a small piece of tissue from the kidneys; then the tissue is examined under a microscope to find out if there is a kidney disease.


Differential diagnosis

Other causes of dark or red urine:

  • Hemoglobinuria: means hemoglobin in the urine,
  • Myoglobinuria: presence of myoglobin in the urine,
  • Food, such as beet,
  • Drugs such as rifampicin, nitrofurantoin,
  • Porphyria: the urine becomes  dark ,
  • Bilirubinuria: obstructive biliary disease.


Treatment for blood in the urine

If blood is visible in the urine, it is necessary to consult a doctor without delay.

Medical Treatments for Hematuria
Many diseases can cause blood in the urine. Some of them have little medical importance and do not require treatment.
Other cases can be serious and need immediate treatment.
Treatment depends on the underlying cause of  hematuria .

Kidney Stones
In most cases of kidney stones , the treatment consists of drinking lots of water and taking pain medications.
Most stones (stones) go through the urinary system alone. In some cases, more important measures may be necessary.
One form of therapy called extracorporeal shock waves uses sound waves to break the stones into very small pieces or sand. The smaller pieces can traverse the urethra more easily, although this may cause some pain.
Another type of therapy is ureteroscopy that serves to locate the stones in the ureter and remove them with a thin, flexible, tube-like tool.

Urinary Tract Infection
Therapy is used to eliminate the bacteria responsible for the infection.
If there is no other significant disease, the patient will probably need a cycle of antibiotics for 3 to 14 days, depending on the source of the infection.

Benign prostate enlargement
Sometimes avoiding medication that irritates the prostate or that acts on the urine stream can help. Rarely, medications or surgery are needed to reduce the size of the prostate.

If a drug causes blood in the urine, the doctor may order the discontinuation of the medication and possibly recommend a viable alternative.
Some medicines only discolor the urine without causing hematuria.
The doctor must determine if they can still be taken.
You should not stop taking a medication before consulting the doctor.

Urinary Tract Obstruction
A blockage usually requires surgery or other procedures to correct or remove the cause.

Damage to tissue
They may heal over time or surgery or other procedure may be necessary to repair the damage and remove damaged tissue.


Natural Remedies for Blood in the Urine

In case of urinary infection, kidney stones or inflammation of the prostate ,  natural nutrition can be very helpful in curing.
Generally, conventional medicine does not indicate a diet to cure illnesses, but only medications.
In my experience, I have seen that the best results are obtained with two types of feed:

  • Dr. D’Adamo and Mozzi Blood Type Diet consists of a different diet according to the type of blood. In particular, it is recommended to avoid dairy products for prostate problems and kidney stones, while for infections you also need to avoid pork, sausage, black pepper, red pepper, creamy desserts, tea and tomatoes.
  • According to Shelton’s hygienism , it is necessary to adopt a healthy lifestyle and a vegan / raw food diet with many raw fruits and vegetables, nuts, seeds and legumes.

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