Unexplained Hematuria: A Guide for Concerned Families

Q: Unexplained Hematuria: A Guide for Concerned Families

Hello： There are many causes of hematuria, with common ones including inflammation of the urinary tract, stones, tumors, and trauma. <br>Hematuria caused by different factors may present with various accompanying symptoms. <br>Generally, physicians must start with the patient's m

Unknown cause

I would like to ask about my father-in-law, who is 68 years old and occasionally experiences hematuria.
He has visited two major hospitals for examinations, but the test results have all come back normal (including tests for the urinary system, blood sugar, kidney stones, etc.).
We are unable to determine the cause, which makes me very worried.
I hope the doctor can provide some answers.
Thank you.

Ya Ya, 30~39 year old female. Ask Date: 2005/07/12

Dr. Chen Sirong reply Oncology

Hello: There are many causes of hematuria, with common ones including inflammation of the urinary tract, stones, tumors, and trauma.
Hematuria caused by different factors may present with various accompanying symptoms.
Generally, physicians must start with the patient's medical history, symptoms, and physical examination, and then arrange further testing based on the patient's condition.
Common tests include intravenous pyelography (IVP), ultrasound, endoscopy, urine cytology, and blood biochemistry and immunology.
Approximately ninety-five percent of hematuria cases can be attributed to a specific cause; understanding the cause of hematuria is essential for appropriate treatment.
Some patients may still not have a determined cause after thorough examination and should undergo regular follow-up checks every three months.
Sincerely, Dr.
Hsiu-Yi Chen, Urology.

Reply Date: 2005/07/12

More Info

Unexplained hematuria, or the presence of blood in the urine, can be a concerning symptom, especially for older adults like your father-in-law, who is 68 years old. While it is reassuring that he has undergone multiple tests at reputable hospitals and the results have come back normal, it is understandable that you and your family are still worried about this symptom.

Hematuria can be classified into two types: gross hematuria, where the blood is visible to the naked eye, and microscopic hematuria, where blood is only detectable under a microscope. The causes of hematuria can vary widely, ranging from benign conditions to more serious underlying issues. Some common causes include urinary tract infections (UTIs), kidney stones, benign prostatic hyperplasia (BPH), and, in some cases, malignancies such as bladder or kidney cancer.

Given that your father-in-law has already undergone tests for urinary system issues, blood sugar levels, and kidney stones, it is essential to consider other potential causes. Here are some suggestions for further evaluation and management:
1. Repeat Urinalysis: Sometimes, a repeat urinalysis can provide additional insights, especially if the hematuria is intermittent. A 24-hour urine collection can also help assess for any abnormalities in kidney function or the presence of blood.

2. Imaging Studies: If not already performed, imaging studies such as a renal ultrasound, CT scan of the abdomen and pelvis, or MRI may be warranted to visualize the kidneys and urinary tract more thoroughly. These tests can help identify structural abnormalities that may not be evident through standard blood tests.

3. Cystoscopy: This procedure involves inserting a thin tube with a camera into the bladder through the urethra. It allows direct visualization of the bladder and urethra and can help identify any lesions, stones, or other abnormalities that may be causing the hematuria.

4. Referral to a Specialist: If your father-in-law has not yet seen a urologist, it may be beneficial to seek a referral. Urologists specialize in urinary tract disorders and can provide a more focused evaluation and management plan.

5. Monitoring and Follow-Up: Since the tests have returned normal so far, it may be appropriate to monitor the situation closely. Keeping a log of when hematuria occurs, any associated symptoms (such as pain, urgency, or frequency), and any potential triggers (such as physical activity or dehydration) can provide valuable information for healthcare providers.

6. Consider Other Factors: Sometimes, medications, supplements, or even vigorous exercise can lead to hematuria. It may be worth reviewing any recent changes in medications or lifestyle that could contribute to this symptom.

7. Emotional Support: It is essential to address the emotional aspect of dealing with unexplained symptoms. Encourage your family to communicate openly about their concerns and seek support from healthcare professionals who can provide reassurance and guidance.

In conclusion, while unexplained hematuria can be alarming, it is crucial to approach the situation systematically. Continued communication with healthcare providers, thorough evaluations, and monitoring will help ensure that any underlying issues are identified and managed appropriately. If your father-in-law experiences any new symptoms, such as pain, changes in urinary habits, or weight loss, it is essential to seek medical attention promptly.

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