Sports hematuria

A Sporthämaturie or Marschhämaturie (preamble Bewegungshämaturie ) is the appearance of blood in the urine ( hematuria ) after exercise. It is generally considered a harmless phenomenon.

causes

A number of possible triggers for sports hematuria have been described, including endurance sports such as jogging , rowing , swimming, and cycling, and contact sports such as football and boxing . About every fourth ultramarathon runner examined has red blood cells (erythrocytes) in the urine after the race .

The causes can be traumatic or non-traumatic. In contact sports, injuries to the kidneys and urinary bladder from direct impacts are believed to be the cause of the bleeding. During long-distance running, especially when the bladder is empty, the rhythmic vibrations can cause the bladder walls to rub against each other and thereby chafe. For hematuria from cycling, bumps from the saddle could be responsible for an injury to the bladder. When swimming and rowing, however, there is no force acting on the internal organs, so the hematuria must be explained differently. Various mechanisms for this have been suggested but never proven. One possibility could be that the redistribution of the blood in the muscles leads to a reduced blood flow to the kidneys ( ischemia ), which then leads to blood escaping from the kidney tissue. Another explanation is that the increased lactate concentration in the blood damages the kidney filter, causing erythrocytes to be excreted in the urine.

clinic

The blood excretion can be so large that the urine turns dark (macrohematuria), but it is often not noticeable without testing. There are test strips that can detect blood components in the urine. The sports hematuria regresses within days after the end of the exercise. In general, it is therefore a harmless phenomenon without any disease value. However, it should be differentiated from other causes, especially if the hematuria has persisted for a long time. It must also be checked whether there is actually a hematuria, i.e. an excretion of blood, or a hemoglobinuria in which only the blood pigment hemoglobin gets into the urine, but no other blood components. This is the case with march hemoglobinuria or sports hemoglobinuria ( English : exercise induced hemoglobinuria ).

Individual evidence

1. ^ Günter Thiele: Handlexikon der Medizin , Urban & Schwarzenberg , Munich, Vienna, Baltimore without year, Volume 1 (A – E), p. 248; Volume 3 (L-R), p. 1555.
2. ↑ ^{a b c d} Angelo Mercieri: Exercise-induced hematuria. uptodate.com, Wolters Kluver. As of October 30, 2019, last accessed on April 3, 2020.
3. ^ Harrison's internal medicine , 19th edition, Georg Thieme Verlag , ABW Wissenschaftsverlag, Berlin 2016, ISBN 978-3-88624-560-4 , ISBN 3-411-02426-7 , p. 802.
4. ↑ Duden : The Dictionary of Medical Terms , 4th Edition, Georg Thieme Verlag, Stuttgart 1985, ISBN 3-13-437804-3 , p. 431.
5. ^ Günter Thiele: Handlexikon der Medizin , Urban & Schwarzenberg , Munich, Vienna, Baltimore without year, Volume 4 (S – Z), p. 2307.
6. ↑ Peter Reuter: Springer Clinical Dictionary , 1st edition, Springer, Heidelberg 2007, ISBN 978-3-540-34601-2 , p. 1738.
7. ^ Roche Lexicon Medicine , 5th edition, Urban & Fischer , Munich, Jena 2003, ISBN 978-3-437-15156-9 , p. 1739.
8. ^ Lexicon Medicine , 4th edition, Verlag Naumann & Göbel, Munich without year [2005], ISBN 3-625-10768-6 , p. 1578.

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