Microscopic Hematuria

What is microscopic hematuria?

“Microscopic” means something is so small that it can only be seen through a special tool called a microscope. “Hematuria” means blood in the urine. So, if you have microscopic hematuria, you have red blood cells in your urine. These blood cells are so small, though, that you can’t see the blood when you urinate.

Symptoms of microscopic hematuria

Most of the time, you will not have any symptoms of microscopic hematuria. Sometimes you may feel a burning sensation when you urinate. Or you may feel the urge to urinate more often than usual.

What causes microscopic hematuria?

Some of the most common causes of blood in the urine include:

  • Kidney infections.
  • Enlarged prostate.
  • Urinary tract (bladder) infection.
  • Swelling in the filtering system of the kidneys (this is called “glomerulonephritis”).
  • A stone in your bladder or in a kidney.
  • A disease that runs in families, such as cystic kidney disease.
  • Some medicines.
  • A blood disease, like sickle cell anemia.
  • A tumor in your urinary tract (this may or may not be cancer).
  • Exercise (when this is the cause, hematuria will usually go away in 24 hours).

How is microscopic hematuria diagnosed?

Your doctor will usually start by asking you for a urine sample. He or she will test your urine (urinalysis) for the presence of red blood cells. Your doctor will also check for other things that might explain what is wrong. For example, white blood cells in your urine usually mean that you have an infection. If you do have blood in your urine, your doctor will ask you some questions to find out what caused it.

If the cause isn’t clear, you may have to have more tests. You might have an ultrasound or an intravenous pyelogram (this is like an X-ray). A special tool, such as a cytoscope or an endoscope, may be used to look inside your bladder. These tests are usually done by a urologist.

How do I give a urine sample?

A nurse will give you an antiseptic wipe (to clean yourself) and a sterile urine collection cup. In the bathroom, wash your hands with soap and warm water first.

  • For women: Use the antiseptic wipe to clean your vagina. Do this by wiping yourself from front to back 3 times before you urinate. Fold the wipe each time you use it, so that you are wiping with a clean part each time.
  • For men: Use the antiseptic wipe to clean the head of your penis. If you’re not circumcised, pull the foreskin back behind the head of the penis before you use the wipe. Move the wipe around the head of your penis before you urinate.
  • Start urinating in the toilet. About halfway through the urination, start catching the urine in the cup.
  • Wash your hands with soap and warm water.
  • Give the sample to the nurse. Someone will look at your urine under a microscope to see if it has blood in it.

Can microscopic hematuria be prevented or avoided?

You may not be able to prevent microscopic hematuria, depending on what causes it. But the Centers for Disease Control and Prevention recommend drinking plenty of fluids, especially when you are exercising.

Microscopic hematuria treatment

If the cause of the blood in your urine is evident, your doctor will probably treat you. Then your doctor will check your urine again to see if the blood is gone. If it’s not, your doctor may perform more tests or refer you to a urologist.

Living with microscopic hematuria

If you have no symptoms of microscopic hematuria, you may not know to alert your doctor. But if you do have symptoms, call your doctor right away. It is always important to find out the cause of blood in your urine.

Questions to ask your doctor

  • What treatment is best for me?
  • What is causing the blood in my urine?
  • Could I have a kidney stone?
  • Are there any medicines that I can take?
  • Will I need surgery?
  • How often do I need to come back for a follow-up visit?
  • Could I have cancer?