Blood in urination with pain, tearing.

A very serious reason for an urgent visit to the doctor is blood when urinating, and especially if such a symptom is accompanied by pain, burning, or if the urine has a specific additional smell. The appearance of blood can indicate a large number of pathologies: some of them are treated quickly and without any problems, while others pose a serious danger to the body.

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Epidemiology

According to statistics, blood in the urine in approximately 50% of cases is a consequence of kidney disease, in 30-35% it is a bladder disease, and in 10% it is a prostate disease.

Relatively rarely, lesions of the ureter manifest as blood during urination.

Most often, this symptom accompanies diseases such as benign and malignant tumors in the urinary system, kidney stones, renal tuberculosis, hydronephrosis, pyelonephritis, and prostatic hyperplasia.

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Causes of blood when you urinate

A person is unlikely to be able to determine the cause of bloody discharge during urination on their own. For example, a good, competent doctor can name more than a hundred possible reasons that can cause such a symptom. Although most often, blood during urination is associated with diseases of the urinary system. These can be:

• vascular blockages;
• cysts;
• tumors of the kidneys or bladder;
• kidney stones;
• prostate adenoma;
• mechanical damage to the urinary or genital organs;
• gynecological problems.

In many cases, blood in the urine is a consequence of tumor growth, both benign and malignant. For example, polyps or papillomas can form in the bladder, which destroy blood vessels and thus provoke the release of blood into the urine.

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Blood in urine with cystitis

Cystitis is an inflammatory reaction that is accompanied by considerable discomfort. Most often, women suffer from cystitis, due to the natural features of the structure of the urinary system.

Blood in urination – hematuria – always attracts the patient’s attention with cystitis. This symptom can be pronounced or insignificant. Depending on this, macro and microhematuria are distinguished.

Microhematuria cannot be noticed by a person: it is determined only by the results of tests, by the presence of blood in the urine. This usually happens with minor inflammation, with a chronic inflammatory process, or with microtrauma.

Macrohematuria cannot go unnoticed: the color of the urine will change to pinkish or dark red, depending on the amount of blood present in the urine.

Blood in the urine can be detected in acute cystitis, or in the exacerbation of the chronic course of the disease, when the permeability of the vascular walls increases, blood clotting decreases, and the smallest vessels are destroyed.

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Risk factors

Most often, blood in the urine is found in people who have certain risk factors in their lives:

• work in hazardous production, in places where heavy metal salts, chemicals, and dyes accumulate;
• regular consumption of alcoholic beverages, heavy smoking;
• the presence of the papilloma virus in the body;
• chronic inflammatory processes in the body;
• conducting radiation and chemotherapy for tumors in other organs;
• frequent and prolonged exposure to cold;
• weak immunity;
• venereal diseases, prostatitis, frequent gynecological problems.

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Pathogenesis

Blood in the urine, which appears as a result of impaired renal function, is most often observed in patients with mesangial or interstitial nephritis.

Necrosis of renal capillaries also plays a significant role in the appearance of blood in the urine.

Blood in the urine often accompanies acute glomerulonephritis and is one of the main signs of the disease.

Kidney diseases often manifest themselves by the appearance of blood during urination, but hematuria in this situation is detected simultaneously with proteinuria, edema, and increased blood pressure. Only in rare situations, with atypical development of nephritis, blood during urination may be absent.

Persistent and painless blood in the urine can be observed in patients over 40 years of age who abuse alcohol and have diseases of the liver, pancreas, and cardiovascular system.

In some patients, blood in the urine may be detected during treatment with sulfonamide drugs, analgesics, streptomycin, and medications containing metal salts.

Less often, blood in the urine can be the result of incorrect or prolonged use of contraceptives, the presence of colds, or excessive physical exertion.

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Symptoms of blood when you urinate

Blood in the urine may not be the only sign of pathology. Depending on the underlying disease, other symptoms may be observed, such as:

• turbidity of urine, the appearance of sediment in it;
• pain in the lower abdomen;
• frequent urination, often with a small volume of urine excreted;
• pain at the end of urination, or throughout urination;
• elevated temperature;
• feeling of weakness, fatigue, headache;
• signs of anemia;
• weight loss, loss of appetite.

If blood is observed in the urine over a long period of time, or if the blood content in the urine is high enough, anemia may develop.

The first signs of anemia may be:

• feeling of weakness, dizziness;
• pale skin (especially on the face), appearance of dark circles under the eyes;
• sensation of noise in the ears;
• fatigue, constant desire to sleep;
• loss of appetite;
• sleep disturbance (restless sleep);
• decreased libido;
• rapid heartbeat, noise when listening to the heart;
• According to the test results – low hemoglobin levels, acidosis, low red blood cell count.

If any of the above symptoms occur, you should already sound the alarm and consult a doctor: you cannot expect the disease to go away on its own. As a rule, everything happens the other way around: the process worsens, and the treatment becomes more complex and lengthy.

According to doctors, patients are most often concerned about the following issues:

• Recently I felt severe pain, but now it is gone, but there is blood during urination. What could this mean?

The reasons may be stones in the urinary system. When filtering in the kidneys, salts are deposited, which crystallize, increasing in size, and causing pain and discomfort to a person. At a certain point, the stone can block the ureter, or move outward, damaging the mucous tissue. Thus, the pain was caused by the movement of the stone along the urinary tract. And blood during urination appeared due to trauma to the mucous by the stone.

• After hypothermia, I began to have frequent urges to go to the toilet, and the release of urine was very painful, and blood was released after urination - literally a few drops.

The listed symptoms clearly indicate cystitis: after hypothermia, the inflammatory process began, irritated tissues of the bladder led to more frequent urges. An additional confirmatory symptom was blood when urinating in the last portion of urine. In such a case, it is necessary to visit a therapist or urologist.

• Does it matter for diagnosis when exactly blood appears: at the end of urination or at the beginning? Or does it not play a significant role?

If you notice blood when urinating, be sure to track exactly when it appears and tell your doctor. Blood at the beginning of urination indicates a pathology in the urethra or prostate gland. Blood at the end of urination means that there is a disease associated with the upper part of the urethra or the neck of the bladder. It also happens that blood appears in the middle of the urination process: such a sign may indicate a disease of the kidneys, bladder or ureters.

• Blood often appears before urination, a few drops. At the same time, the urine is clean and has a normal color. What could it be?

Sometimes drops of blood before urination indicate tumor processes. These may be polyps in the urethra, angiomas or malignant tumors. In rare cases, such a symptom may accompany chronic urethritis, when the entire urethra becomes permeable and bleeds easily.

• If there is severe pain when urinating and blood, but not constantly, but periodically. Sometimes the lower back hurts, especially on the right. What disease can be suspected?

In case of urolithiasis, urine analysis will always indicate the presence of red blood cells: sometimes there will be quite a lot of them, and sometimes – less. The fact is that the stone injures the urinary ducts from the inside: in one case, this leads to severe bleeding, and in another – to completely unnoticeable. In most patients with urolithiasis, the appearance of blood is accompanied by severe pain. This condition is usually called renal colic.

• At first I had a fever and thought I had a cold. But then I started urinating frequently with blood. How serious is it?

Any inflammation can provoke an increase in body temperature. And if it is an inflammation of the urinary tract, then hematuria can also occur at the same time - blood during urination. The cause of such a process can be pathogenic bacteria - both non-specific (streptococci, staphylococci) and specific pathogens. It is necessary to contact a urologist and undergo an examination.

• Blood clots suddenly appeared when urinating. There is no pain or any other symptoms. Is this a tumor?

Indeed, with malignant tumors, even very severe bleeding may occur, since the tumor, when growing, can damage nearby vessels. It is especially alarming when blood clots after urination are found in older patients - 50-60 years old. Such symptoms - blood during urination without pain - are considered typical for bladder cancer.

Often you can hear from young people who are heavy smokers the following phrase: "A blood clot fell out when urinating - but I am not sick with anything." According to statistics, cancerous tumors of the urinary tract are found three times more often in smokers. This happens because some carcinogenic components of tobacco smoke are excreted from the body with urine, which leads to the development of a malignant process.

• I have been experiencing pain and blood when urinating for several days now. Which doctor should I see?

Pain, burning when urinating and blood in the urine are considered characteristic signs of infectious diseases that are sexually transmitted. Such diseases include gonorrhea, mycoplasma, ureaplasma, chlamydia, herpes. Bacteria get on the epithelium, destroy its cells and change the acidity of the environment. Directly under the epithelium there are a large number of sensitive nerve endings: it is the irritation of these endings that causes the sensation of pain and burning.

Problems with urination often begin after contracting a sexually transmitted infection. For example, with gonorrhea, mucus with blood may be observed during urination, sometimes with an admixture of pus. With herpes or trichomonas infection, the genitals itch and swell, and in men, drops of blood also appear at the end of urination. The diagnosis is established by a venereologist: they are the first to be contacted with such symptoms.

• I have been having sex with one partner for over a year now, and every time I urinate blood after sex. Why?

This can happen if there are cicatricial changes at the sites of the hymen rupture. The scars contribute to tissue tension, which leads to the urethra approaching the vagina: this prevents the natural closure of the external opening of the urethra. As a result, chronic infection penetrates the urethra, and cystitis with the release of a small amount of blood makes itself known after each sexual contact. A urologist and gynecologist can solve the problem.

• Almost always there is blood from the anus when urinating, also often I find traces of blood on the underwear. There is no pain. Do I need to see a doctor?

Blood from the anus can appear against the background of many diseases. This happens with anal fissures, intestinal polyposis, ulcerative colitis or infectious lesions. Sometimes blood is released during pregnancy, with helminthiasis. In any case, it is necessary to consult a doctor to determine the cause of such a symptom. After all, in some cases, blood from the anus can be an indirect and the only sign of a cancerous process in the rectum.

• In the morning after urination, drops of blood: no symptoms during the day. Can we suspect a disease?

With urethritis - an inflammatory process in the mucous membrane of the urethra - blood is released only at the end, or after urination. Such inflammation can be provoked by the activation of opportunistic microflora, or by infection with sexually transmitted diseases. If you see blood only in the morning, this does not mean that there is no blood during the day: you just cannot see it. A urine test and a consultation with a urologist will help establish the correct diagnosis.

• Why does blood appear when women urinate?

According to statistics, cystitis most often manifests itself in women this way. In advanced cases, ordinary cystitis turns into a hemorrhagic form, in which urine turns an intense red color. In addition, blood can be detected in women with prolonged use of oral contraceptives: hormones reduce the tone of the walls of the urinary tract, urine stagnation develops and, as a result, inflammation. And the inflammatory process, as you may have guessed, is often accompanied by the release of blood.

Often, blood from the vagina gets into the urine when urinating: for this reason, a urine test is never taken during menstruation.

• Is blood in urine dangerous during pregnancy?

Fortunately, in most cases, blood in the urine of many pregnant women is physiological or idiopathic. The reasons for this phenomenon are considered to be the strongest hormonal changes, pressure of the uterus and fetus on the urinary system, damage to the capillaries in the area of the renal cups (due to increased intra-abdominal pressure). This symptom disappears on its own after the birth of the child. However, in order to make sure that there is no danger, it is better to undergo a preliminary examination.

• How often does blood occur when urinating in men, and what is it associated with?

Minor bleeding during urination is not a pathology in many cases: if a man works hard, damage to blood vessels may be associated with this. This symptom will disappear on its own after a long rest. However, one should not discount possible pathology: in men, blood may appear with prostate diseases, oncology, and contact sexually transmitted infections.

• How serious is it if parents find blood in their children's urine?

In addition to the general factors that we have already discussed above, there are also a number of known causes that cause blood to appear when urinating in children. Blood may appear not as a result of kidney or urethral diseases, but due to a violation of hematopoiesis or vascular diseases. This means that the blood becomes more liquid, and the vessels are more vulnerable. This happens in patients with hemophilia, thrombocytopenia, Werlhoff's disease and Schonlein-Henoch's disease.

Blood in the urine of newborns is often a consequence of uric acid diathesis, when the renal structures are damaged by crystallized urinary salts.

In addition, blood in a baby’s urine test may appear after viral infections or after taking non-steroidal anti-inflammatory drugs (as a side effect).

Consequences and complications

If you try to treat blood in the urine on your own, or do not treat the disease at all, then complications may quickly develop:

• a secondary infection sets in;
• pathogenic microorganisms become resistant to the action of antibiotics;
• urethritis and glomerulonephritis develop;
• an acute disease transforms into a chronic one;
• anemia develops due to constant blood loss;
• renal failure develops;
• acute urinary stagnation occurs.

To avoid such complications, you need to see a doctor in a timely manner, without trying to cure the disease yourself and without hoping for self-healing.

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Diagnostics of blood when you urinate

To determine the cause of blood in the urine, the patient must undergo diagnostics. Only with the results of the examinations in hand, the doctor will be able to prescribe the correct treatment.

To establish a correct diagnosis, the following tests may be required:

• Laboratory tests:
  • general urine analysis;
  • general blood test;
  • blood biochemistry, coagulation assessment;
  • urine culture to determine possible infection;
  • urine analysis according to Nechiporenko.
• Instrumental diagnostics:
  • intravenous urography procedures;
  • ultrasound examination of the urinary system;
  • ultrasound examination of the genital area (in women, the uterus and appendages are examined, and in men, the prostate gland);
  • cystoscopy.
  • Consultations with specialists: gynecologist, proctologist, urologist, venereologist, surgeon, infectious disease specialist, etc.

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Differential diagnosis

Differential diagnostics are carried out with the following pathological conditions:

• Pseudohematuria is a condition when a person sees red urine, but the laboratory does not detect blood in it. Often, pseudohematuria can be observed with hemoglobinuria, during treatment with analgin, tetracycline, tuborine, and also when eating beets or dark-colored carbonated drinks.
• Urethrorrhagia is bleeding from the urethra, which is observed during trauma or tumor processes.

Treatment of blood when you urinate

Blood in the urine is not an independent disease, but only a sign of some pathology, so it is pointless to talk about a specific and unified treatment plan in this case. After reviewing the diagnostic results, the doctor will prescribe the patient those medications that affect the underlying disease that caused the appearance of blood in the urine. Such drugs can be antibiotics, antiviral drugs, non-steroidal anti-inflammatory drugs, etc.

In certain cases – if a benign or malignant tumor is detected – the doctor may prescribe surgical treatment.

If blood components are present in the urine in large quantities, then hemostatic drugs may be required against the background of urgent hospitalization of the patient: such a condition often poses a danger not only to the health, but also to the life of the patient.

Medicines are prescribed as follows:

• antibiotics – after identifying a specific infectious agent;
• antiviral drugs;
• vasoconstrictors, hemostatic agents;
• preparations for washing the urethra and bladder.

	Method of administration and dosage	Side effects	Special instructions
Cefuroxime	It is used for urinary tract infections, on average 750 mg three times a day.	Allergies, diarrhea, nausea, candidiasis, convulsions, and hearing loss may occur.	Allergy to Cefuroxime may develop in patients sensitive to penicillin.
Nimesulide	It is used for mechanical damage to the urinary tract, such as urolithiasis. The standard dose is 100 mg orally, twice a day.	Development of dyspepsia, headache, and allergies is possible.	Nimesulide is not prescribed for chronic renal failure.
No-shpa	It is used for nephrolithiasis, urethrolithiasis, cystitis, pyelitis, and bladder spasms. The standard dose is 1-2 tablets up to 3 times a day.	Headache, dizziness, and decreased blood pressure may occur.	No-shpa is not used to treat children under 6 years of age.
Vikasol	It is used to stop bleeding, 15-30 mg per day orally, or 10-15 mg per day as intramuscular injections.	Allergies are rare.	Vikasol can be used from the neonatal period, according to indications.

Vitamins

When treating bloody discharge during urination, it is important to replenish the body's deficiency of vitamins and minerals, because a person loses many useful components with blood. Of particular importance are preparations containing iron and vitamins, which facilitate its absorption.

Most often, the doctor recommends taking the following multivitamins:

• Tardiferon (a combination of iron and vitamin C);
• Gemsineral TD (contains iron, folic acid and vitamin B ₁₂ );
• Globiron (contains iron, folic acid and vitamins B ₆ and B ₁₂ );
• Fenuls (contains iron, folic acid, vitamins C, B ₁, B ₂, B ₆, B ₁₂ ).

There are also many other multivitamin preparations known to support the body when blood is excreted in the urine. Sometimes the doctor prescribes monovitamins in the form of injections: pyridoxine, cyanocobalamin, folic acid. These vitamins are prescribed depending on the type and extent of blood excretion during urination.

Physiotherapy treatment

Physiotherapy may be prescribed not during an exacerbation, but at the stage of remission of an inflammatory disease, if it is diagnosed against the background of the appearance of hematuria.

For example, patients with nephritis are prescribed:

• consumption of mineral waters;
• sodium chloride or carbon dioxide baths;
• amplipulse treatment;
• microwave treatment;
• ultrasound;
• UHF therapy;
• direct current therapy.

In case of nephritis, physiotherapy procedures are contraindicated:

• in the active stage of the inflammatory process;
• in the terminal phase of chronic pyelonephritis;
• with polycystic disease;
• in case of hydronephrosis in the decompensation stage.

Patients with cystitis are recommended:

• UHF treatment;
• infrared irradiation of the bladder projection area;
• sodium chloride bath;
• paraffin (ozokerite) locally.

Contraindications in this case are:

• prostate adenoma of the second and third degree;
• diseases requiring surgical treatment;
• leukoplakia;
• ulcerative necrotic cystitis.

In the presence of malignant tumors, any type of physiotherapy is contraindicated.

Folk remedies

Blood in the urine is a very serious symptom, in all cases indicating the development of some disease, sometimes even a very dangerous one. You cannot count on the condition normalizing on its own: often the disease only progresses, and the symptoms become more pronounced and severe. That is why folk remedies can be used only when the cause of this symptom is precisely established, and the doctor does not mind using such treatment.

Trying to treat hematuria with herbs and folk methods on your own, without knowing the true cause of the disease, is absolutely unacceptable.

• Pour 30 g of parsley seeds with 400 ml of boiling water and leave for an hour. The resulting medicine should be drunk throughout the day, little by little.
• Take equal amounts of chamomile flowers and horsetail grass. Brew one tablespoon of the mixture in 250 ml of boiling water and drink throughout the day. A new portion of the medicine should be prepared every day.
• Grind 2 tablespoons of yarrow and brew in 250 ml of boiling water. Drink the infusion 30 ml (about 1 tablespoon) several times a day.
• Make tea or compote from cranberries and lingonberries. Drink as often as possible.

You can also add lingonberry leaves when brewing regular tea. Drink this tea 3-4 times a day, 200 ml.

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Herbal treatment

Herbs are often used to speed up the healing process and to relieve painful symptoms of diseases. If blood appears during urination, the following herbal remedies can help:

• Celandine herb in the form of an infusion eliminates pain and inflammation already on the second day after starting to use it.
• Flax seed – used in the form of an infusion (1 teaspoon per 200 ml of boiling water), which stops the development of inflammation and improves the composition of urine.
• Linden blossom tea has strong anti-inflammatory and antimicrobial properties.
• A decoction of rowan berries – relieves pain and burning during cystitis, strengthens blood vessels, improves the quality of blood clotting.
• Cranberry - leaves and fruits - are a natural antiseptic and strengthen blood vessels and bladder walls.

In combination with drug therapy, herbal treatment will help to quickly overcome the disease and strengthen the body as a whole.

Homeopathy

Homeopathic remedies can be used only after determining the cause and source of the appearance of blood during urination, and also in the absence of the need for surgical, transfusion and intensive resuscitation treatment.

If blood appears during urination, it is recommended to pay attention to the following homeopathic remedies:

• Arnica Montana – helps with bleeding associated with damage to blood vessels. Used internally in a dilution of x3, 3, 6.
• Millefolium (yarrow) – used for capillary bleeding, to increase the activity of the blood clotting system, in small dilutions (x1, x2, x3), often.
• Ferrum aceticum (iron acetate) - used for blood in the urine caused by trauma to the kidneys or urinary tract, as well as when a stone passes along the ureter. Dilution x3, 3, 6.
• Crotalus - prescribed for diffuse kidney damage, blood clotting disorders, hemorrhagic vasculitis. Dilutions 6, 12, 30.

Prevention

To prevent hematuria, you need to follow these generally accepted rules:

• do not neglect intimate personal hygiene;
• treat various chronic diseases in the body in a timely manner, including urinary tract infections;
• prevent the development of dysbacteriosis;
• avoid hypothermia;
• If you experience any suspicious symptoms of pain, consult a doctor.

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Forecast

The prognosis depends entirely on the underlying disease that gave rise to such a symptom as blood in the urine. For example, if bloody discharge appears due to cystitis, then such a pathology with proper treatment lasts for about a week. If cystitis becomes a chronic disease, then exacerbations can often remind of themselves.

It is safe to say that blood in the urine is a serious symptom that should never be ignored. And treatment of this condition should only be carried out under the supervision of a medical specialist.

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