Men often go to the doctor complaining of blood in their urine. At the Yusupov Hospital, doctors find out the reason for the appearance of blood in the urine of men using modern instrumental and laboratory research methods. To treat the underlying disease that caused the appearance of blood in the urine, the latest medications registered in the Russian Federation are used. They are highly effective and have minimal side effects.
If indicated, minimally invasive and abdominal surgical interventions are performed. The issue of the need and type of surgical treatment is discussed at a meeting of the Expert Council with the participation of professors, associate professors and doctors of the highest category. The medical staff is attentive to the wishes of patients.
What does blood in urine mean in men? There are 2 types of hematuria (blood in the urine) – macrohematuria and microhematuria. In the first case, the man notices a change in the color of the urine; in the second, red blood cells in the urine are found during a laboratory test. Blood in a man's urine can appear without pain or with pain. If there is pain, doctors first eliminate the pain, then treat hematuria.
Causes of blood in a man's urine
Why does blood appear in the urine of men? The urine of a healthy person is straw-yellow in color. The appearance of blood in a man’s urine indicates the presence of a pathological process in the organs of the urinary system. Blood in a man's urine appears in the presence of the following factors:
- Excessive physical activity;
- Injuries;
- Pyelonephritis;
- Prostatitis, prostatic hyperplasia;
- Urolithiasis;
- Urethritis.
Blood in the urine in men appears in the presence of sexually transmitted diseases, malignant tumors, and when taking certain medications (acetylsalicylic acid, heparin, rifampicin).
Some factors and diseases (foreign body, enlarged prostate, cancer) cause the appearance of blood in the urine with pain and blood at the beginning of urination, and others at the end (anemia, leukemia, blood clotting disorders, kidney malignancies).
Treatment of hematuria
Food dyes, such as beets, can also change color. But the presence of red blood cells in the urine is a serious deviation. If a man experiences bloody urine when urinating, you should not take the risk and treat yourself. Diagnosis and treatment should only be carried out by a doctor. It is best to do this in a specialized clinic. This is an opportunity for a comprehensive examination, correct diagnosis and adequate treatment. The main direction is to eliminate the cause of the disease. Be attentive to your health, take care of yourself.
Diagnosis of diseases that cause blood in urine
In order to carry out effective therapy for the disease that caused the appearance of blood in the urine of a man, urologists at the Yusupov Hospital conduct a comprehensive examination of the patient using the latest equipment from the world's leading manufacturers and laboratory tests. If blood appears in a man’s urine without pain, doctors use those diagnostic methods that are necessary in the presence of one or another cause of hematuria.
Asymptomatic microhematuria can develop with chronic kidney disease, infectious or viral diseases, menstruation that has begun or recently ended, or after recently performed urological manipulations (catheter installation). In this case, hemostatic therapy and repeated urine analysis are performed.
When examining a patient with blood in the urine visible to the naked eye, a general urinalysis is performed. Worm-shaped clots may form in the urine, indicating their formation in the upper urinary tract. Large, shapeless clots form in the bladder.
Blood in the initial portion of urine appears after injury, as a result of inflammation or tumor growth of the urethra. With total hematuria, all portions of urine are uniformly stained with blood. This symptom is characteristic of diseases of the kidneys, ureter, prostate and bladder. In men, blood is released at the end of urination in the presence of a tumor of the bladder neck, prostatitis, inflammation or tumor of the seminal tubercle.
Pain combined with bloody urine in men may indicate a possible cause of bleeding. If there are stones in the ureter, pain appears in the lumbar region on the affected side before the onset of hematuria. If the ureter is blocked by blood clots, men experience pain after bleeding in the urine. With bladder tamponade, pain occurs after the appearance of blood in a man’s urine.
During the initial examination of the patient, doctors pay attention to the following symptoms:
- Hemorrhagic rashes on the skin and mucous membranes indicate possible diseases of the blood coagulation system, hemorrhagic fever with renal syndrome;
- Edema that increases blood pressure indicates kidney disease;
- An increase in body temperature can be caused by an infectious disease;
- Lymph nodes can become enlarged due to blood diseases, cancer, and infectious diseases.
For men, when blood appears in the urine, urologists perform a digital rectal examination and examination of the external opening of the urethra.
An accessible and sensitive diagnostic method is urine testing for the presence of hemoglobin. False-positive results are possible with myoglobinuria and hemoglobinuria, false-negative results are possible when patients take vitamin C and acetylsalicylic acid preparations. The positive result obtained from this diagnostic method is confirmed by doctors at the Yusupov Hospital with the data of a general urine analysis and sediment microscopy. In some cases of blood in the urine of men, Nechiporenko studies may have additional diagnostic value.
Microscopy of sediment using a modern phase contrast microscope allows for topical diagnosis of hematuria. If laboratory technicians detect unchanged red blood cells in the urine, there is a high probability of a urological disease with the source of hematuria located in the collecting system, ureter or lower urinary tract. The presence of altered red blood cells and casts in the sediment indicates kidney disease.
In order to determine the source of blood in the urine of men, a three-glass test is performed. If the source of bleeding is located in the male urethra, blood will be in the first portion of urine. In the case of isolated hematuria in the third portion of urine, the pathological focus is located in the neck of the bladder.
For microscopic examination, men collect an average portion of urine freshly released during urination, which laboratory assistants immediately centrifuge for 10 minutes in a 15-mm flask at a speed of 2000 per minute. During a microscopic examination, at least 10-20 fields are evaluated under four hundred times magnification. The presence of three or more red blood cells in the microscopic field is evidence of microhematuria.
In the presence of gross hematuria, nephrologists at the Yusupov Hospital prescribe the following instrumental studies:
- Ultrasound examination of the kidneys, bladder, prostate;
- Excretory urography (performed with normal levels of creatinine and blood urea);
- Cystoscopy (performed after exclusion or in the absence of suspicion of the presence of an acute inflammatory process in the organs of the genitourinary system).
Doppler ultrasound is performed to assess blood flow in the renal vessels. The morphological diagnosis is clarified using a biopsy of the kidney, pelvis, bladder, ureter, urethra, and prostate. Using computer and magnetic resonance urography, the anatomical features of the urinary tract are visualized in detail. Retrograde ureteropyelography and ureteropyelocalicoscopy are used if the source of blood in the urine is suspected to be papillary tumor diseases of the upper urinary tract.
When blood appears in the urine in men suffering from systemic diseases, severe proteinuria, elevated creatinine and urea levels are detected in patients with hematuria, patients are consulted by a nephrologist. A consultation with a hematologist is prescribed if men with blood in the urine have an enlarged liver and spleen, or subcutaneous hemorrhages. When hematuria is combined with diarrhea, patients are advised by an infectious disease specialist. If men have blood in their urine in combination with persistent pyuria that is resistant to antibiotics, a consultation with a phthisiatrician is prescribed.
Urination with blood - causes
If, during the act of urination, blood clots or fresh blood are constantly present in the urine, then this may be a signal indicating the following kidney damage:
- Damage may be traumatic.
- The presence of a neoplasm in the kidneys in the form of a tumor or cyst.
- Presence of kidney stones.
- Infectious kidney diseases (pyelonephritis).
- Vascular embolism is a blockage of blood vessels.
- Glomerulonephritis.
- Polycystic kidney disease.
When a tumor or polyp appears in the bladder, no pain or discomfort is noted in the early stages of the development of the pathological process. If urination with blood is accompanied by spasmodic pain, then this indicates an infection.
Stones formed in the renal pelvis and the infectious process often cause acute pain, which can radiate to the lower back, bladder and genitals. Infectious diseases of the genitourinary system are also characterized by increased body temperature, increased blood pressure and general weakness.
Treatment for men with blood in their urine
If there is blood in the urine of men, hemostatic therapy is prescribed with vikasol, calcium chloride, dicinone, etamsylate. Patients are given intravenous drips of aminocaproic acid. If a man has blood in his urine with pain, antispasmodics and analgesics are prescribed. Then urologists and nephrologists treat the disease that causes blood in the urine in men.
If blood appears in the urine of a man suffering from hematological diseases, treatment with blood components or transfusion of fresh frozen plasma is carried out, depending on the identified defect in the hemostatic system. For infectious and inflammatory diseases of the urinary system, antibiotics, anti-inflammatory drugs are prescribed, and infusion-detoxification therapy is carried out. Patients suffering from kidney diseases undergo pathogenetic therapy of the underlying disease with glucocorticoids and cytostatics.
The goal of surgical treatment for hematuria is to completely stop bleeding. Operations are performed in the presence of the following indications: recurrent hematuria caused by urological diseases that require surgical intervention (neoplasms, stones, narrowing), gross hematuria, which leads to the development of anemia and bladder tamponade. If, after hemostatic therapy, blood does not appear in the urine, surgical treatment of the underlying disease is carried out as planned. If bleeding continues, emergency surgery is performed for life-saving reasons. If blood in a man’s urine causes tamponade, the bladder is washed to remove clots. If the patient cannot be cured of the underlying disease, if bleeding continues, minimally invasive surgical methods are used.
If blood appears in a man’s urine, call the contact center. If there is bleeding, patients are admitted to the Yusupov Hospital around the clock. Doctors will carry out hemostatic therapy, determine the cause of the appearance of blood in the urine, and prescribe treatment for the underlying disease that caused the hematuria.
Causes of pus in urine
Pus in the urine can also indicate kidney disease, which is often detected. A person may have papillary necrosis, tuberculosis infection in the kidneys, bacteria in this organ that provoke a pathological process. Also reasons may be:
- hydronephrosis
- pyelonephritis, acute or chronic
- pyelitis in chronic form
- urolithiasis with complications
- ascending infection in the ureters
- penetration of pus into the urinary tract from organs that are located nearby
- acute cystitis
How is hematuria diagnosed?
A healthcare professional diagnoses hematuria or the cause of hematuria by:
- disease history
- physical examination
- Analysis of urine
- additional testing
Disease history
Taking a medical history can help a healthcare professional diagnose the cause of hematuria. He will ask the patient to provide a medical history, an overview of symptoms, and a list of prescription and over-the-counter medications. The healthcare professional will also ask about current and past medical conditions.
Physical examination
During a physical examination, the health care provider will often tap your abdomen and back to check for pain or tenderness in the bladder and kidney areas. A healthcare professional can perform a digital rectal exam on a man to identify any prostate problems. A doctor may perform a pelvic examination on a woman to look for the source of possible red blood cells in the urine.
Digital rectal examination . A digital rectal exam is a physical examination of a person's prostate and rectum. To perform the exam, the health care professional has the person bend over a table or lie on their side with their knees close to their chest. The health care professional places a lubricated gloved finger into the patient's rectum and feels the part of the prostate gland that lies in front of the rectum. A digital rectal exam is used to check for prostate inflammation, an enlarged prostate, or prostate cancer.
Gynecological examination . A pelvic examination is a visual and physical examination of a woman's pelvic organs. The healthcare worker has the woman lie on her back on the examination table and place her feet on the corners of the table or in supports. The health care professional looks at the pelvic organs and places a lubricated gloved finger in the vagina to check for problems that may be causing blood in the urine.
Analysis of urine
A healthcare professional can test your urine in the office with a dipstick or send it to a laboratory for analysis. Sometimes urine dipstick tests can be positive even if the patient does not have blood in the urine, resulting in a "false positive" test. A healthcare professional may look for red blood cells by examining the urine under a microscope before ordering further tests.
Before obtaining a urine sample, the health care provider may ask the woman when she last menstruated. Sometimes blood from a woman's menstrual cycle can get into her urine sample and cause a false positive test for hematuria. The test should be repeated after the woman stops menstruating.
Additional testing
Sometimes the health care professional will test the patient's urine again. If urine samples reveal too many red blood cells, your healthcare provider may order additional tests:
- Blood analysis . A blood test involves drawing blood at a health care provider's office or commercial establishment and sending the sample to a laboratory for analysis. A blood test may reveal high levels of creatinine, a waste product of normal muscle breakdown, which may indicate kidney disease. Other blood tests can detect signs of autoimmune diseases, such as lupus, or other diseases, such as prostate cancer, that can cause hematuria.
- Computed tomography (CT). CT scans use a combination of X-rays and computer technology to create images of the urinary tract, especially the kidneys. The healthcare provider may give the patient a solution to drink and an injection of contrast material. CT scans require the patient to lie on a table that slides into a tunnel-shaped device that receives X-rays. A radiologist performs the procedure in an outpatient center or hospital, and a radiologist interprets the images. The patient does not require anesthesia. A CT scan can help your doctor diagnose urinary tract stones, obstructions, infections, cysts, tumors, and traumatic injuries.
- Cystoscopy . Cystoscopy is a procedure performed by a urologist, a doctor who specializes in urinary problems, to view a patient's bladder and urethra using a cystoscope, a tube-like instrument. A health care professional performs a cystoscopy in his or her office, outpatient center, or hospital. The patient may need pain medications. Cystoscopy can detect cancer in a patient's bladder.
- Kidney biopsy . A kidney biopsy is a procedure that involves removing a small piece of tissue from the kidney. A health care professional performs the biopsy at an outpatient center or hospital. The healthcare professional will give the patient light sedation and local anesthesia. In some cases, the patient will require general anesthesia. A pathologist—a doctor who specializes in diagnosing disease—examines tissue in a laboratory. A biopsy can help diagnose if hematuria is caused by kidney disease.
- Magnetic resonance imaging (MRI). An MRI is a test that takes pictures of a patient's internal organs and soft tissue without the use of X-rays. A specially trained technician performs the procedure at an outpatient center or hospital, and a radiologist interprets the images. The patient does not require anesthesia, although patients with fear of confined spaces may receive light sedation. An MRI may include an injection of contrast material. In most MRI machines, the patient will lie on a table that slides into a tunnel-shaped device that may be open or closed at one end. Some machines allow the patient to lie in a more open space. During an MRI, the patient must remain completely still while the technician takes the images. During the procedure, the patient hears a loud mechanical knock and a buzzing sound coming from the device.
