Blood in Urine: Causes, Concerns, and Next Steps

Q: Blood in Urine: Causes, Concerns, and Next Steps

Hello： In response to your question... <br>The occurrence of hematuria after exercise is often benign. <br>It may be caused by the movement of urine in the bladder during physical activity, which can exert external force on the bladder wall and lead to microvascular rupture. <br>

Could you please provide more details about the issue of hematuria?

Doctor, I previously experienced reddish urine after running (without any blood clots).
I underwent a kidney imaging examination, and the results showed no inflammation or stones.
However, the doctor mentioned that a small segment of the ureter connecting to the kidney seems to be compressed and slightly indented.
I was advised to return for a follow-up in three months.
I would like to ask:
1.
Although urination is not painful, when I feel the urge to urinate (with a small amount of urine), I tend to push a bit, which results in reddish urine.
What treatment should I pursue?
2.
Why does the slight indentation in the ureter cause my urine to appear red? What could have caused this indentation? I have previously engaged in intense exercise without experiencing this issue.

3.
The doctor advised me to drink plenty of water and return for a follow-up in three months, but sometimes my urine is still reddish, which makes me quite anxious.
Should I really wait for three months, or is there something else I should do? Thank you for your response.
I appreciate it.

junjay, 20~29 year old female. Ask Date: 2004/10/12

Dr. Yang Jun reply Internal Medicine

Hello: In response to your question...
The occurrence of hematuria after exercise is often benign.
It may be caused by the movement of urine in the bladder during physical activity, which can exert external force on the bladder wall and lead to microvascular rupture.
However, it is essential to rule out other pathological causes of hematuria before making this diagnosis.
The issues raised in the text can be discussed in detail with a urologist.

Reply Date: 2004/10/12

More Info

Blood in urine, or hematuria, can be a concerning symptom that warrants careful evaluation. In your case, it seems that you have already undergone some diagnostic imaging, which is a good first step. Let's address your questions one by one.

1. Treatment for Blood in Urine: Since you mentioned that you experience red urine when you exert pressure to urinate, it’s important to understand the underlying cause. The fact that you have a history of a compressed ureter could be contributing to your symptoms. A narrowed or compressed ureter can lead to increased pressure in the urinary system, which may cause bleeding. Treatment options may vary depending on the severity of the compression and the underlying cause. If the compression is significant, it may require intervention, such as ureteral stenting or surgery. However, if the compression is mild and not causing significant obstruction, conservative management, including hydration and monitoring, may be appropriate. It’s crucial to follow up with your healthcare provider for further evaluation and to discuss potential treatment options.

2. Why a Compressed Ureter Can Cause Red Urine: A compressed ureter can lead to increased pressure in the urinary tract, which may cause small blood vessels to rupture, resulting in blood in the urine. This can happen due to various reasons, including trauma, inflammation, or anatomical abnormalities. The fact that you previously engaged in vigorous exercise without issues suggests that the compression may have developed over time or could be related to a specific incident. It’s essential to monitor your symptoms and report any changes to your doctor.

3. Follow-Up and Monitoring: While your doctor has advised you to wait three months for a follow-up, it’s important to listen to your body. If you continue to experience red urine, especially if it is accompanied by pain, changes in urination patterns, or any other concerning symptoms, you should seek medical attention sooner. Blood in urine can be a sign of various conditions, including urinary tract infections, kidney stones, or more serious issues like tumors. Therefore, if you have persistent symptoms, it’s advisable to contact your healthcare provider for further evaluation.

In summary, while it’s good that you have had imaging studies that ruled out stones and inflammation, the presence of blood in your urine should not be ignored. It’s essential to maintain open communication with your healthcare provider, adhere to their recommendations, and advocate for your health. If you feel that your concerns are not being adequately addressed, seeking a second opinion from a urologist may provide additional insights and peace of mind. Remember, your health is paramount, and it’s always better to err on the side of caution when it comes to symptoms like hematuria.

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