how do you explain and when to worry? – breaking latest news

The presence of blood in the urine is not necessarily a worrying sign, however it should never be underestimated. This does not mean that it is necessary to rush to the ER, but It is essential to talk to the doctor who will evaluate the investigations to be done to trace the cause. In most cases, hematuria, the medical term for the presence of blood in the urine, can in fact be investigated with an outpatient procedure. Only in exceptional cases, for example when blood clots and severe urinary retention are present, does an urgent check-up make sense.

What are the possible causes of hematuria?

First of all it is necessary to distinguish between microematuria and macrohematuria – he said Walter Artibani, former professor of urology at the University of Verona and general secretary of the Italian Society of urology -. In the first case, the urine is still clear and the presence of red blood cells can only be identified with a urine test. Macroematuria instead recognizable with the naked eye. The presence of blood in the urine indicates that it is somewhere in the urinary tract there is a more or less serious injury. Upstream of this manifestation there can be kidney diseases such as glomerulonephritis, urinary infections, stones, malformations up to urinary tract tumors. There are cases where what looks like blood in the urine is actually not. In fact sometimes it can happen that the abnormal coloring is due to the ingestion of particular foods or drugs. For example if you eat a lot beetroot it may happen to see colored urine, the same is true when taking particular drugs such as rifampicin at high dosage.

What investigations can help to trace the cause?

A fundamental investigation pelvic and urinary tract ultrasound. It allows to evaluate the kidneys, looking for more or less evident urinary masses, but also to highlight a possible dilation of the upper urinary tract (hydronephrosis) and possibly bladder defects within the urinary tract. Based on the type of hematuria, the presence or absence of other symptoms and the outcome of the ultrasound, it is often possible to identify the type of disease responsible for the bleeding. When persistent microhematuria is present there are ways to deepen its meaning, in particular the counts of Addis, to quantify the red blood cells emitted in 24 hours, and the Farley’s test, that is the microscopic evaluation of the morphology of red blood cells. Those red blood cells that pass through the renal glomeruli without being altered identify a possibly benign non-glomerular pathology (stones, urinary tract infections, etc.). In reverse the presence of deformed red blood cells it must suggest glomerular diseases. In case of macrohematuria, even if episodic, the diagnostic path goes through the evaluation of the cells that are present in the urineand to verify that no tumor-like cells are present. When urothelial tumors are particularly aggressive, they leave their cells to exfoliate in the urine. From a probabilistic point of view, especially when the age is over 50-60 years, one of the most frequent causes of macrohematuria is presence of bladder growths, which are veryfrequent in smokers and ex-smokers because the poisons of the combustion products of cigarettes are eliminated through the urine and their stagnation in the bladder causes these neoformations with great frequency. Among the different investigations that may be worth performing are also included urethrocystoscopy and Uro-Tac, that is an abdominal CT scan with iodized contrast medium in the vein that allows to better delineate the entire morphology of the urinary tree from the bladder to the kidneys.