Blood in Urine: A Guide for Parents of Young Girls

Hematuria issues

Hello Doctor: My daughter is 9 years old and recently told me that she feels pain while urinating (but there is no frequency of urination).
After visiting the urology department at a teaching hospital, her urine test results showed hematuria (Blood+1), while everything else was normal.
The doctor immediately performed a renal ultrasound, which also returned normal results.
However, the doctor advised that further immunological testing was necessary.
After being referred to a pediatric allergist and immunologist for blood tests, the results indicated that her immune system is normal, and there is no need for concern; we can continue to monitor her condition.

However, due to my daughter's medical history and current situation, I am cautious and would like to ask the doctor some questions online.
Thank you!
1.
My daughter underwent a renal ultrasound at the hospital shortly after birth, which revealed hydronephrosis (at that time, there were no symptoms).
Follow-up examinations showed that the hydronephrosis had resolved by the time she was about 8 or 9 months old, and the recent ultrasound results were normal.

2.
She still experiences bedwetting (approximately once every 10 days), which worries me.
Additionally, she has had a history of mild hematuria (twice), during which the doctors only advised her to drink more water without conducting further tests.

Given this information, I would like to know if my daughter's mild hematuria requires any additional detailed examinations, or if regular follow-up is sufficient.
Furthermore, the doctor has started her on medication for bedwetting; typically, how long should this type of medication be taken? Are there any side effects?
Finally, thank you for providing this valuable opportunity for consultation.

Mama, 0~9 year old female. Ask Date: 2004/02/12

Dr. Gu Qingxian reply Pediatrics

Regarding your letter, I understand that your daughter has had mild hematuria for a long time and has undergone a renal ultrasound, which returned normal results.
Additionally, her immune function is also normal.
Therefore, it can be inferred that the mild hematuria is not caused by any significant underlying condition, and it is sufficient to monitor her urine every month.
As for the bedwetting phenomenon, it is mostly caused by psychological stress and is treatable.
Since there has only been one oral treatment, it is unlikely to cause side effects.
The duration of treatment will depend on the therapeutic outcomes.
Sincerely, Guo Qingxian, February 14, 1993.

Reply Date: 2004/02/12

More Info

Understanding blood in urine, especially in young girls, can be a source of concern for parents. It's important to approach this issue with a clear understanding of potential causes, necessary evaluations, and treatment options.

Firstly, the presence of blood in urine, known as hematuria, can arise from various factors. In young children, it may be due to urinary tract infections (UTIs), kidney stones, trauma, or even benign conditions like exercise-induced hematuria. Given that your daughter has experienced blood in her urine along with pain, it is prudent to consider these possibilities. The fact that her ultrasound results were normal is reassuring, but it does not completely rule out all potential issues.

Since your daughter has a history of renal issues, such as the neonatal kidney dilation that resolved, it is wise to remain vigilant. Although her recent immunological tests returned normal results, ongoing monitoring is essential. The intermittent nature of her hematuria and the previous occurrences suggest that further investigation may be warranted, especially if the symptoms persist or worsen. It might be beneficial to consult a pediatric nephrologist for a more specialized evaluation, particularly if there are any changes in her urinary patterns or if she experiences additional symptoms like fever, abdominal pain, or changes in her overall health.

Regarding her bedwetting, which occurs approximately every ten days, this is a common issue in children and can be influenced by various factors, including developmental delays, stress, or even genetic predisposition. The treatment for bedwetting often involves behavioral strategies, but medications can also be prescribed to help manage the condition. The duration of medication use can vary; some children may require treatment for several months, while others may need it for a longer period. Common medications include desmopressin, which reduces urine production at night, and imipramine, which can help with bladder control. Side effects can occur, including headaches, nausea, or changes in mood, so it's essential to maintain open communication with your healthcare provider about any concerns.

In summary, while your daughter's current situation with hematuria and bedwetting may not indicate a severe underlying condition, it is crucial to continue monitoring her symptoms closely. Regular follow-ups with her healthcare provider, including potential referrals to specialists, will ensure that any emerging issues are addressed promptly. Encourage her to stay well-hydrated and maintain good hygiene practices, as these can help reduce the risk of urinary tract infections. Lastly, don't hesitate to seek further medical advice if you notice any changes in her symptoms or if new concerns arise. Your proactive approach to her health is commendable and will contribute significantly to her well-being.

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