Understanding Hematuria
Hematuria means blood in your urine. It can be visible to the naked eye (gross hematuria) or only seen under a microscope (microscopic hematuria). Finding blood in your urine understandably causes concern, but most causes are benign. However, hematuria always deserves evaluation because it can indicate kidney stones, infection, benign growths, or—less commonly—cancer. Dr. Libby investigates systematically to find the cause.
Possible Causes of Hematuria
- Kidney stones – Blood comes from stone irritating the lining
- Urinary tract infection – Infection causes bleeding and blood in urine
- Enlarged prostate – Stretching causes bleeding, especially with urinary retention
- Bladder or kidney tumors – Can bleed and show as blood in urine
- Benign prostate hyperplasia – Enlarged prostate causes microscopic bleeding
- Glomerulonephritis – Kidney filtration problem causing blood in urine
- Polycystic kidney disease – Multiple kidney cysts prone to bleeding
- Bladder polyps – Non-cancerous growths that bleed
- Blood clotting disorders – Difficulty clotting leads to hematuria
- Vigorous exercise – Rare cause, usually resolves quickly
Dr. Libby's Evaluation Process
When you come in with hematuria, Dr. Libby starts with a thorough history—when you first noticed blood, whether it hurts to urinate, any recent trauma, medications, and family history. He performs a urinalysis to confirm blood and check for infection, crystals, or protein. Then he typically orders imaging (ultrasound or CT scan) to look at the kidneys and evaluate for stones or masses. Cystoscopy (a camera examination of the bladder) is often done to visualize the bladder lining and urethra directly, looking for tumors, polyps, or other bleeding sources.
Cystoscopy Explained
Cystoscopy is a simple office procedure where Dr. Libby passes a thin, lighted scope through the urethra into the bladder. It takes 5-10 minutes and causes minimal discomfort. You'll receive numbing medication first. The scope lets Dr. Libby see the entire bladder lining and urethra in detail. If he finds a small polyp or growth, he can remove it right there. Cystoscopy is usually the final piece of the hematuria puzzle because it directly visualizes where blood is coming from.
What Happens After Diagnosis
Once Dr. Libby identifies the cause, treatment depends on what he finds:
- Kidney stones: Treated with ESWL, ureteroscopy, or other procedures (see kidney stones page)
- UTI: Treated with antibiotics; hematuria resolves once infection clears
- Bladder polyp or tumor: Removed during cystoscopy; further treatment as needed based on pathology
- No abnormality found: Usually benign; follow-up hematuria testing monitors for future problems
- Kidney disease: Referred to nephrologist for management
When to Call Dr. Libby
Call our office immediately if you notice blood in your urine, especially if accompanied by flank pain, fever, or difficulty urinating. Don't wait and don't assume it's harmless—hematuria always deserves evaluation. Early detection of problems like bladder cancer means better outcomes.