Blood in the urine is an important warning to urge patients and professionals to take actions for timely evaluation and counseling so to
deduce its possible causes and reasonable care. If not, delaying diagnosis may occasionally cost patients' health and life. But, don't
worry; let me explain to and help you. Read on.
What is hematuria?
Hematuria is a medical term to denote blood in urine; "hem- and "-uria" mean blood and urine respectively.
It has been categorized as follows:
bothered or disturbed by an emotional turmoil?
Simply speaking, medical professionals do not want to leave the malignancy - cancer undiagnosed if any possible.
How possible would the patients with microhematuria be found to have a cancer inside their urinary tract?
In general, about less than 5% of patients will be found to have a cancer. In other words, you would be correct to say you have no cancer
in more than 95% of times even though not having any professional training. Since cancers may eventually kill the patients if left
undiagnosed, medical professionals insist on pursuing thorough evaluation, counseling, and follow-up on microhematuria.
A review on microhematuria from comprehensive textbooks and available literatures will reveal a long list of more than100 clinical
conditions which may cause microhematuria. Common examples include, not limited to:
Largely, all the causes for microhematuria may manifest as gross hematuria. Among those, stones and tumors are most common, and
anyone with total painless gross hematuria should alert patients, especially in the elderly and smokers, and professionals to look for
bladder cancer; never delay.
Before going to see doctors, always collect and bring the detailed information on the onset, degree, duration, interval, evolution, and
progress of hematuria - micro- or gross, and its potential related symptoms such as pain and difficulty in peeing over time to doctor for
analysis + physical exam + tests as needed so to deduce most possible diagnosis for most reasonable care for best possible outcome
from medical care.
their professional confidence and proficiency despite being qualified with diplomas, licenses, and certificates.
No, most of times, the cause for microhematuria is evident and sure, but doctors still cannot tell you every time exactly what may cause
microhematuria because it is hard to prove at times and may be multi-factorial.
How will you be followed after initial evaluation if nothing important is found?
If the results of all tests and procedures turn out to have nothing clinically significant / important, it's reasonable to stop here and do
nothing further for now, but just check urinalysis once every 4-6 months and repeat imaging study and cystoscopy once in 1-2 years.
Such practice is based on the assumption that a tumor may be just too small to be detected by all means and it may grow in size over
time, especially for those of high risks - the elderly, the smoker, etc.
Note, any occurrence of gross hematuria after finding nothing significant in thorough investigation for microhematuria should warn
patients and doctors to repeat thorough evaluation as described above.
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- Reported in 2016 AUA convention in San Diego from NW University in Chicago.
- Estimated incidence of microhematuria is about 2-30%; higher rate in older people & smokers.
- Defined as =/> 3 rbc.
- Cohorts of 11,902 patients from 2008-2011 with 71% females, 48% Caucasian, 22% AA, 4% Hispanic, 3% Asian, and 22%
unknown; a median of 5.8 years of follow-up for diagnosis of bladder cancer, kidney cancer, and urolithiasis.
- 61% have 3-10 rbc /hpf at initial urinalysis, and 35.2% had at least one more urinalysis in the 6 months after initial diagnosis.
- The rates of diagnosis, i.e., the odd to have diagnosis: 4.7% for bladder cancer, 3.1% for kidney cancer, and 16.5% for urolithiasis.
- If >100rbc/hpf on the first urinalysis is linked to higher rate of these conditions – bladder cancer, kidney cancer, and urinary stone;
and men and older patients are at the highest risk of malignant diagnoses.
- Bladder cancer linked to risk of second primary cancer.
accessory retrograde pyelogram, ureteroenphroscopy
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