Macrohematuria
| Classification according to ICD-10 | |
|---|---|
| R31 | Unspecified hematuria |
| ICD-10 online (WHO version 2019) | |
Macrohematuria describes the presence of blood in the urine that can be seen with the naked eye , in contrast to microhematuria , which can only be diagnosed using more extensive diagnostic methods (urine stix, microscopy). See also: hematuria .
Symptoms
The main symptom is the visible red or brown discoloration of the urine. Blood clots can also be visible in the urine. Macrohematuria can be painful or painless.
There are three types of macrohematuria:
- Initial macrohematuria; d. H. at the beginning of micturition ( urination ) there is blood
- terminal macrohematuria; d. H. at the end of micturition there is blood
- total macrohematuria; d. H. the urine is red in color throughout micturition
causes
The direct causes of macrohematuria are diverse. The cause of bleeding can lie in the entire area of the lower urinary tract , i.e. the renal pelvis , ureter , urinary bladder or urethra . The type of macrohematuria (initial, terminal or total) can provide an indication of the location of the cause. In the case of an initial macrohematuria, the cause is more likely to be found in the urethra, in the case of a terminal one more in the bladder neck, and in the case of a total in the bladder or the ureters and kidneys.
- Injuries
- Inflammation
- Stones
- Kidney tumors
- Lower urinary tract tumors
- Prostate cancer
- benign prostate enlargement
- Disorders or drugs affect blood clotting
- foreign body
- nephrogenic (kidney-related) causes, e.g. B. due to membrane damage in the kidney (e.g. IgA nephropathy)
In urology , painless macrohematuria is considered suspicious of a bladder tumor until proven otherwise .
Differential diagnosis
Discoloration of the urine from other causes must be distinguished, for example from medication, chemicals, beetroot or brick flour sediment . There are also other diseases that can cause discoloration of the urine, such as porphyria . With these causes, however, no red blood cells are detectable in the urine .
Diagnosis
Here the entire urinary tract must be examined. In addition to sonography , this may include computed tomography of the abdomen. A cystoscopy is particularly necessary in painless macrohematuria to rule out a bladder tumor. The urine test is used to diagnose a urinary tract infection and, along with sonography, is the first diagnostic method.
therapy
Therapy depends on the underlying cause. Macrohematuria can be a life-threatening emergency, which is why a doctor should be consulted immediately.
