How is hematuria diagnosed?
There are many ways and approaches to diagnose hematuria and its cause(s). These include:
- Physical Symptoms and examination of medical history,
- Physical examination, and
- Chemical analysis with urinalysis.
The role of physical symptoms and clinical history:
Physical symptoms along with your medical and family history, can provide important clues to the cause of blood in the urine. Your physician may therefore ask a range of related questions. You must carefully notice your symptoms and provide accurate information to your doctor about your condition, any recent medication, etc. You may be asked about:
- Any medical condition(s) you are getting treatment for;
- Medicines you are currently taking;
- Hematuria episodes in the past;
- Recent food intake or dietary changes;
- Recent events of strenuous exercise/workout;
- Your periods (for women);
- Any experience of pain while urinating;
- Flank pain or bladder irritability;
- Whether blood in the urine is in the initial or terminal part of the urine stream;
- Fever, chills, sweats, bleeding from any other part;
- Increase in the frequency of urinating;
- Nausea and vomiting coinciding with flank pains.
The information provided to the doctor will help them: a) determine the possible cause of hematuria; b) decide about further investigation and treatment.
Physical examination to aid in the diagnosis of the cause of blood in urine:
Your doctor may examine your abdomen, back, flanks, and bladder area for any visible/palpable signs of an illness. For men over 50, a digital rectal examination may also be carried out for a possible prostate-related condition. For women, an examination of the pelvic organs could be conducted to diagnose the cause of blood in the urine.
Urinalysis to confirm the diagnosis of hematuria:
Visible or gross hematuria should immediately be reported to the doctor unless you are sure it is not due to benign conditions such as the intake of certain foods or drugs. The clinical diagnosis of a gross and microhematuria begins with a urinalysis test, which can be the key to tracing the source of blood in the urine.
How to test blood in urine?
A urine test can be performed in a laboratory or at home using blood in urine test strips. Also called hemastix, hematuria dipsticks, or simply dipsticks, these narrow strips for test in urine come with one or more reagent test pads to check the presence and quantity of blood in the urine. When dipped in the urine, the reagent pad changes color in response to the number of red blood cells detected in the sample. The color of the pad is then matched with the corresponding key to interpret the results. An at-home UA test is a quick and easy way to find the presence of urinary blood. A multiparameter urine dipstick test, like Urinox-10, tests ten different parameters, including blood, white-blood-cells, and protein in the urine.
Test strips for blood in the urine (also called hematstix or hematuria sticks) are an easy way to check hematuria.
What are normal and abnormal ranges of blood in the urine?
The range of up to 3 or 4 RBC/HPF (high-power field) is seen as the normal range when the urine sample is microscopically examined. Normal values may vary from lab to lab. If your urine test turns positive with an above-normal count of red blood cells, immediately discuss it with your doctor.
How to read and interpret the results of blood in urine dipstick test?
In a professional or at-home dipstick test, a bright yellow pad color indicates negative blood in urine results.
A positive test is characterized by the following observations:
- Green spots on the reagent pad if trace amounts of non-hemolyzed red blood cells are detected;
- Change in the reagent pad color to light green if small amounts of blood are detected;
- Change in the reagent pad color to dark green if large amounts of blood are found.
Conclusion
Blood in the urine is not a normal finding, but it is neither uncommon nor necessarily a cause for alarm. In acute and benign cases, the normal color of the urine is restored after a few episodes of urination. If you continue to notice blood in the urine or your test repeatedly turns positive, it should be reported to the healthcare provider. Your healthcare practitioner will investigate further to determine the source and underlying cause. Your provider will conduct/order a urinalysis to confirm a diagnosis. Results from the urinalysis test may necessitate other tests such as blood urea nitrogen, urine culture, serum creatinine, and complete blood count. Your doctor may also order more advanced tests like a CT or MRI scan, ultrasound examination, or cystoscopy to examine the anatomy of the bladder and urethra to diagnose the cause and assess the health of your organs. The course of treatment depends on the subsequent findings.
