Macrohematuria

Under one Macrohematuria one understands the presence of blood in the urine, which is macroscopic, i.e. visible to the naked eye. In contrast, there is microhematuria. In this case, the blood can only be determined under a microscope or other diagnostic procedures.

What is macrohematuria?

Hematuria refers to the presence of red blood cells, i.e. blood in the urine, and macrohematuria, a red coloration of the urine that can be seen with the naked eye. The bleeding may or may not be painful.

Nevertheless, in both cases, a doctor should be consulted as soon as possible, as it is unusual and usually pathological. Inflammation, urinary stones, tumors and a mixing of the menstrual blood can be possible causes.

The hematuria are divided according to the source of the bleeding and can be of glomerular or post-glomerular origin. Macrohematuria is usually a postglomerular hematuria, so the structure and shape of the red blood cells are less damaged.

causes

Macro hematuria can have many causes. It can be caused by menstrual blood, physical stress, sexual activity, viral diseases, trauma, or an infection. Infections, or kidney stones in the urinary tract, i.e. the renal pelvis, ureters, bladder, and urethra, often result in blood in the urine. Other serious causes of macrohematuria are tumors of the kidney or the bladder, as well as inflammation of the kidneys, urinary tract, bladder or prostate in men.

Genetic polycystic kidney disease can also be a factor. This is characterized by many grape-shaped, fluid-filled cysts that over time make the kidneys larger and destroy the kidney tissue. A bleeding disorder, such as hemophilia, or sickle cell anemia can also be the trigger for macrohematuria.

Sickle cell anemia is an inherited condition in which the red blood cells are abnormal, crescent-shaped and less able to carry oxygen to the tissues of the body. They often clog the small blood vessels, disrupt healthy blood flow and cause bleeding.

Symptoms, ailments & signs

Macrohematuria is primarily expressed by the visible red or brown color of the urine. Blood residues or blood clots may also be visible in the urine. The disease can be painless, in some cases it causes severe, usually burning pain when urinating. The affected person has to urinate excessively frequently.

The severity of these symptoms depends on the type of disease. The initial macrohematuria manifests itself in the fact that small amounts of blood are noticed in the urine, which usually only occur at the beginning of urination. In terminal macrohematuria, the blood residues appear at the end of micturition. Total macrohematuria is associated with visible blood in the urine that occurs throughout urination.

Symptoms are usually noticed every time you urinate, but can vary widely. Externally, apart from the blood in the urine, the disease cannot be determined. However, in the course of the disease, an increasing feeling of illness can arise, which is characterized by paleness and sweating. This can be accompanied by gastrointestinal complaints such as nausea, vomiting, diarrhea, constipation and heartburn. In addition, a mild fever can set in, which is often accompanied by chills and tiredness.

Diagnosis & course

There are many tests that can be used to diagnose macrohematuria. A urinalysis is a urine sample that is examined. The urine sample is collected in a special container and sent to the hospital laboratory for analysis. The nurse can use a U-stick to test in advance whether it is actually blood.

The next step is to diagnose the cause of the macrohematuria. For this, the doctor first takes a proper medical history. If this suggests a reason, investigations must be carried out accordingly. Infection, kidney disease and tumors must be excluded.

The presence of white blood cells signals a urinary tract infection. Misshapen and clumped erythrocytes, as well as large amounts of proteins, also known as proteinuria, can be an indication of kidney disease. The urine can also be examined for the presence of cancer cells.

A blood test can determine the presence of high levels of creatinine. This is a normal waste product of muscle breakdown and can be an indicator of kidney disease. A biopsy of the kidney tissue can also be helpful. The removed tissue is then examined by a pathologist for diseases. A cystoscopy, in turn, is used to check the urethra and urinary bladder for possible pathological macroscopic tissue changes. Masses and cysts can also be seen with an ultrasound or computed tomography. If the cause of the gross hematuria is diagnosed, appropriate treatment methods must be initiated.

Complications

Primarily those affected suffer from bloody urine due to the macrohematuria. For many people, blood in the urine can lead to a panic attack or continued sweating, significantly reducing their quality of life. As a rule, the further course of the disease strongly depends on the cause of the macrohematuria, so that a general prediction of this disease is usually not possible.

Bladder cancer can also reduce the patient's life expectancy if the tumor has already spread to other regions of the body. An infection of the urinary tract can also be responsible for the macrohematuria, although those affected also suffer pain when urinating. It is not uncommon for the pain when urinating to lead to psychological complaints or other depressive moods.

In many cases, the macrohematuria can be treated with the help of antibiotics. There are no complications. If the treatment is successful, the life expectancy of the person affected is not restricted. Furthermore, in the case of cancer, the cancer must be removed. In general, it cannot be predicted whether this will lead to a positive course of the disease or a reduction in life expectancy.

When should you go to the doctor?

If blood builds up in the urine after doing hard physical work or intense sporting activities, it may be a one-off event. If the organism is overloaded, there is a possibility that blood vessels burst and leaked blood is excreted in the urine. If there is an improvement within a few hours, no doctor is required. A doctor's visit must be made if the blood is noticed in the urine for several days or repeatedly when using the toilet. If the blood percentage increases, there is also a need for action.

If there are additional symptoms in the abdomen, swelling or a feeling of pressure near the bladder or intestines, a doctor should clarify the symptoms. Changes in the amount of urine excreted is another sign of an inconsistency. If the amount of urine decreases despite constant hydration, a doctor is required. The cause of the observation must be investigated and treated. If you have high blood pressure, abnormal heart rhythm or burning pain when urinating, you should see a doctor. Fatigue and chills are warning signs of the organism for an existing health impairment. If they occur in connection with vomiting, nausea or diarrhea, a doctor should be consulted. If the person concerned suffers from a feeling of illness or a decrease in his performance, he should consult a doctor.

Treatment & Therapy

Macrohematuria is treated based on the diagnosed cause. If there is no serious medical condition causing it, no treatment is necessary. Hematuria caused by an infection is cured with the help of an antibiotic.

A urinalysis should be repeated after six weeks. Kidney stones are often eliminated in the urine on their own. It is important to drink a lot here so that these are rinsed out. If these are too large, however, stone fragmentation by shock waves must be used. How a tumor is treated depends on its stage. Small and previous tumors of the bladder are removed with a small operation. The procedure is performed through the urethra with an endoscope.

The removed tissue is then passed on to the pathology department for further microscopic examinations. If the tumor is larger, the entire urinary bladder must be removed and a replacement made. A macrohematuria therefore has many treatment methods.

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Outlook & forecast

Since it is not an independent disease, the relief of the symptoms depends on the curability of the primary disease. In some of those affected, it is blood that naturally escapes during menstruation in women. Spontaneous healing can therefore be expected as soon as the bleeding time is over. In addition, sexual activities can injure the vessels in the abdomen. Here too, spontaneous healing can be expected within a short time.

However, if the bleeding is based on the presence of foreign bodies in the organism, medical care is required. In the case of kidney stones, removal of the foreign body must be initiated so that recovery can take place. Medical care is also required if there is inflammation in the kidney area. The administration of medication kills the pathogens and prevents them from multiplying. If the person concerned suffers from a blood clotting disorder, a life-threatening condition can develop if the disease progresses poorly.

Without medical care, a further increase in complaints can be expected. Therefore, in the case of macrohematuria, it is fundamentally important to clarify the cause in order to establish the prospect of a cure. In particular, persistent or increasing bleeding indicates a serious underlying disease.

prevention

Macrohematuria is difficult to prevent. Since this has many different causes, only the corresponding causes can be prevented. An infection of the urinary tract can be prevented with the help of an adequate supply of water and a balanced diet. Likewise the formation of kidney stones. A bladder tumor cannot always be prevented. However, smoking nicotine is often a cause of tumor development.

Aftercare

After the actual treatment of the macrohematuria, those affected need ongoing care. In addition to regular medical examinations and the use of other therapies, a change in lifestyle is also part of the follow-up care. Those affected must now try to build up their usual quality of life. Sometimes it can help to go to a self-help group.

Depending on the type of cancer, nutritionists, sports groups and other bodies must also be consulted. The aftercare plan is drawn up together with the doctor and is based on the symptoms, the general course of the disease and the prognosis. In the first phase, when patients are still processing the consequences of the disease and treatment, follow-up care is particularly important. It is crucial to support the patient until a remission is achieved.

Macrohematuria can lead to various complaints and complications if it is not treated properly or in time. Many sufferers also suffer from depression or other psychological moods, which can have a very negative effect on the quality of life of the person concerned. You continue to suffer from severe fatigue and exhaustion and can no longer actively participate in everyday life. The further course of the disease depends very much on the exact time of diagnosis, so that no general prediction can be made about it.

You can do that yourself

Macrohematuria can have a wide variety of causes. Even if it can be diagnosed or at least suspected by the patient, self-therapy is strongly discouraged. Some causes of macrohematuria can be treated and cured well under medical supervision, while others can be caused by a life-threatening disease. A patient who detects or suspects macrohematuria in himself should therefore urgently consult a doctor.

If a specific diagnosis of the causes and the underlying disease is available, the doctor will create a therapy plan for the patient and discuss it with him. Now the patient can do a lot to contribute to his recovery by sticking to the therapy plan and following the recommendations of his doctor. Depending on the diagnosed cause, different therapeutic approaches are necessary. Some therapies require surgery, while others require regular pills.

Often, diet plans or even a complete change in diet and lifestyle follow in a second step. Every patient can make a major contribution to their own well-being by understanding the therapeutic approach and consistently striving to adhere to the guidelines. This also includes attending any check-ups.