Persistent Hematuria: Should You Be Concerned?

Long-term hematuria?

I have been experiencing hematuria for five consecutive years, with urine tests showing +1 to +2 results.
I have undergone microscopic examinations three times, which also revealed 6-9 red blood cells.
Both urine and blood tests have consistently returned normal results, and I have had ultrasounds performed.
Doctors have advised that I should just continue monitoring the situation.
I didn't pay much attention to this before, but after reading some information, I have become quite concerned.
Given that it has been five years without any discomfort and all general tests are normal, what is the likelihood of urinary tract or kidney cancer? Typically, if it were cancer, wouldn't it grow over time? Since there have been no changes in five years, should I be less worried? Are there cases where individuals have experienced hematuria for decades without any abnormalities? This situation has caused me significant anxiety.
Thank you for your response.

beforly, 40~49 year old female. Ask Date: 2021/12/20

Dr. Wu Jiyu reply Internal Medicine

There are many causes of hematuria, ranging from stones, glomerulonephritis to tumors.
If there are no other abnormalities (such as proteinuria, renal function impairment, or abnormal ultrasound findings), please continue with regular follow-ups.
Thank you for your inquiry.
The Nephrology Department at Changhua Hospital cares about you.

Reply Date: 2021/12/20

More Info

Persistent hematuria, or the presence of blood in urine over an extended period, can understandably be a source of concern for many patients. In your case, having experienced hematuria for five years, coupled with normal urine and blood tests, as well as ultrasound results, suggests that while the situation warrants monitoring, it may not necessarily indicate a serious underlying condition.

Hematuria can be classified into two types: gross hematuria, where blood is visible to the naked eye, and microscopic hematuria, where blood is only detectable under a microscope. Your reports indicate microscopic hematuria, with red blood cells present in the range of 6-9 per high power field, which is relatively low. The fact that you have had consistent results over five years without any significant changes is reassuring.
In terms of cancer risk, it is important to note that while persistent hematuria can be associated with conditions such as urinary tract infections, kidney stones, or tumors, the absence of other symptoms and the stability of your condition over time are positive indicators. Typically, malignancies tend to present with additional symptoms, such as weight loss, pain, or changes in urinary habits. Moreover, cancers often show progression over time, which does not seem to be the case with your situation.

There are documented cases of individuals experiencing chronic hematuria for years without any serious underlying pathology. For instance, benign conditions such as thin bladder walls or benign prostatic hyperplasia in men can lead to persistent hematuria without significant health implications.
It is also worth considering that psychological factors can exacerbate your concerns. The anxiety stemming from the fear of potential malignancy can lead to distress, as you mentioned experiencing depression related to this issue. It is crucial to address both your physical health and mental well-being. Engaging in open discussions with your healthcare provider about your fears and concerns can help alleviate some of the anxiety associated with your condition.

In conclusion, while persistent hematuria should always be monitored, the stability of your condition over five years, along with normal diagnostic tests, suggests a lower likelihood of serious disease. However, it is essential to maintain regular follow-ups with your healthcare provider to ensure that any changes in your condition are promptly addressed. If you continue to feel anxious or depressed about your health, consider seeking support from a mental health professional. They can provide strategies to help manage your anxiety and improve your overall quality of life.

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