Gross hematuria – causes, treatment and prevention

Gross hematuria

If the urine suddenly turns red to rusty brown, this is referred to as macrohematuria , i.e. blood in the urine. It always represents a serious warning and should be clarified by a specialist in any case.

What is gross hematuria?

In gross hematuria, the blood in the urine is visible to the naked eye, unlike in microscopic hematuria. Although small amounts of blood that are not visible can occur in the urine of a healthy person, larger and, above all, visible amounts always represent a serious symptom of a possible disease.

Since gross hematuria is often painless, especially in the case of tumor diseases, it should not be taken lightly and should always be medically clarified.

causes

There is a wide range of possible causes of gross hematuria. Especially in young people, an insufficiently detectable cause is relatively common. The bleeding usually stops on its own after a short time.

In people over 50, however, it can hide a more serious illness. One of the most serious is a tumor in the kidneys, bladder or prostate. The most common causes are injuries or inflammation of the urinary tract or kidneys. They are usually accompanied by severe pain. Other causes can be kidney or bladder stones, polyps or foreign bodies.

In some cases, medications and a blood clotting disorder can also cause gross hematuria. The underlying disease or the source of the bleeding can only be adequately clarified by a specialist. Since gross hematuria does not necessarily have to be accompanied by pain, the painless form is usually considered primarily suspect of cancer until this disease can be ruled out and another cause found.

Diseases

When to the doctor?

Blood in the urine may appear after heavy physical activity. Sports training sessions can also lead to overloading of the body and thus bursting of smaller blood vessels in the abdomen. In these cases, the blood in the urine recedes within a short time in most cases. The body is to be spared. A doctor’s visit is only necessary in these situations if the blood appears in the urine the following day.

Gross hematuria is often a spontaneous occurrence of blood in the urine for no apparent reason. A doctor should be consulted as there may be injuries to internal organs. If other symptoms such as abdominal pain , a feeling of pressure or swelling occur, a doctor should be consulted. If the blood in the urine increases continuously, a doctor is needed to carry out further tests. If there are problems with urination or a noticeable change in the amount of urine, a doctor must be consulted.

If other symptoms such as dizziness , impaired consciousness or high blood pressure occur, a doctor’s visit is also necessary. The loss of blood volume is so great that it puts a strain on the entire organism. People who suffer from a blood clotting disorder should see a doctor as soon as possible as soon as gross hematuria develops.

diagnosis and course

In the case of gross hematuria, the family doctor should be consulted first, who will then refer you to a specialist in urology or gynecology. If gross hematuria occurs suddenly and severely, accompanied by severe pain , fever and poor general condition, the emergency services must be called immediately, as this may be an emergency.

In most cases, a urine and blood test is carried out first as part of the diagnosis. In this way, certain causes such as inflammation or blood clotting disorders can already be substantiated or ruled out. An anamnesis can be helpful to clarify possible side effects of medication as well as previous diseases of the kidneys and urinary tract.

In addition to these examinations, sonography in particular can provide information about the cause of gross hematuria. In this way, bladder or kidney stones as well as foreign bodies or tumors can be detected. Another diagnostic procedure is the cystoscopy . In this way, tumors of the bladder and urinary tract can be detected, as well as polyps or other pathological changes such as injuries. A computed tomography examination of the kidneys can also be helpful in diagnosing gross hematuria.

complications

Gross hematuria can lead to various complications. First, the blood can cause a blockage in the urinary tract and thus trigger various symptoms. Acutely, there is urinary retention with severe pain, later urinary retention and kidney failure can occur. The residual urine in the bladder and urinary tract can also cause a urinary tract infection, often accompanied by the formation of bladder stones. If the course is severe, blood poisoning with life-threatening complications can result.

Further complications depend on the causative disease. Gross hematuria secondary to internal injury is a clear warning sign of inflammation and anemia, while gross hematuria secondary to a tumor can lead to serious physical problems over time. If only the blood clotting is disturbed, this indicates an incorrect medication, which can lead to other problems in addition to the blood in the urine.

When treating gross hematuria, the drugs administered can initially lead to an increase in symptoms. This increases the risk of the above complications if no other measures are taken to strengthen the urinary tract (bladder tamponade, etc.). Surgery brings with it additional complications that depend on the causative disease, the stage of gross hematuria, and the patient’s constitution.

treatment and therapy

Gross hematuria itself is just a sign of the disease. The treatment depends on the cause of the disease. In case of inflammation, anti-inflammatory drugs, as well as antibiotics , are usually prescribed. Depending on the condition, in-hospital monitoring may be required.

If medication is causing the bleeding, the medication regimen will be reviewed and changed. Appropriate medication is also prescribed in the event of a possible blood clotting disorder. Depending on where they occur, urinary stones are treated with so-called spasmolytics, i.e. antispasmodics. It is also recommended that you drink plenty of fluids to make it easier for you to get rid of the stones.

If the stones are already too large to be excreted naturally, they are removed using a snare or shock wave lithotripsy. With the latter, the stones are shattered with shock waves. However, long-term consequences for the kidneys cannot be ruled out.

If polyps are the cause of gross hematuria, they are usually removed in a minimally invasive manner. Treating a tumor is more difficult. Depending on the location, benign tumors are surgically removed. In the case of malignant tumors, the treatment depends on the location of the tumor on the one hand and the stage of the cancer on the other. A single tumor is usually surgically removed.

In addition, radiation therapy can support the success of the treatment, or it can be used as an alternative to surgery. If the tumor has already formed metastases, the treatment is much more difficult. Chemotherapy is used as standard here, in addition to surgical intervention to remove the tumor tissue.

outlook and prognosis

Gross hematuria can occur from a variety of diseases and causes. For this reason, the further course depends very much on the exact cause and the underlying disease. Direct treatment that immediately leads to a positive course of the disease is not possible in every case.

In most cases, gross hematuria occurs due to a kidney stone or inflammation in the kidneys. The symptoms do not disappear on their own and must be treated by a doctor in any case. In most cases, these complaints are also associated with severe pain. However, other disorders can also cause gross hematuria.

Especially in cancer patients, the life expectancy of the patient may be limited by gross hematuria. In most cases, kidney stones or inflammation of the kidneys can be treated relatively well with antibiotics and increased intake of fluids. The symptoms of gross hematuria usually disappear. If a tumor is responsible for the blood in the urine, it must be removed. However, the further course depends on the condition of the patient and the severity of the tumor.

prevention

Gross hematuria itself is seldom preventable because it is merely a symptom. However, some diseases such as kidney inflammation or urinary stones can be largely avoided by drinking enough fluids and eating a balanced diet .

Regular emptying of the bladder also prevents inflammation, as dangerous germs are regularly flushed out. Furthermore, good self-observation ensures that possible warning signs are recognized at an early stage and thus more serious illnesses are recognized in good time. This is an important indicator, especially in the case of cancer.

Dorothy Farrar

Hello and welcome to my Health Guide & Encyclopedia! My name is Dorothy Farrar, and I'm the founder and main author of this platform.
My passion for health and wellness started at a young age when I became interested in the connection between the food we eat and the way we feel. This fascination led me to study nutrition and dietetics in college, where I learned about the importance of a balanced diet and the impact of various nutrients on the body.

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