Microscopic Hematuria

What is microscopic hematuria?

Microscopic hematuria is blood in the urine. “Microscopic” means something is so small that it can only be seen through a special tool called a microscope. So, if you have microscopic hematuria, you have red blood cells in your urine that can’t be seen with the naked eye.

Symptoms of microscopic hematuria

Most of the time, you won’t have 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?

Many times, there is no cause for microscopic hematuria. It comes and goes on its own. Other times, it may be caused by:

  • 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 (may or may not be cancer)
  • 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. They will test your urine (urinalysis) for the presence of red blood cells. Your doctor will also check for other things that might explain what’s wrong. For example, white blood cells in your urine usually means 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 need more tests. These may include:

  • A blood test
  • An ultrasound
  • A computed tomography (CT) scan
  • A magnetic resonance imaging (MRI) test
  • An intravenous pyelogram. This is like an X-ray that looks at your kidneys and bladder
  • A special tool, such as a cytoscope or an endoscope, may be used to look inside your bladder. This type of test is usually done by a special doctor called 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. If you are menstruating, tell your doctor before you give your urine sample.

  • 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 recommends drinking plenty of fluids, especially when you’re exercising.

Microscopic hematuria treatment

If your doctor finds what’s causing the blood in your urine, they will treat that problem. Later, they 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 is causing the blood in my urine?
  • Could I have a kidney stone?
  • What treatment is best for me?
  • Are there any medicines that I can take for this problem?
  • Will I need surgery?
  • How often do I need to come back for a follow-up visit?
  • Could I have cancer?
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