Blood in Urine Test

Sometimes, blood in urine is not visible to the naked eye and the presence of RBCs can only be detected by a lab test called urine analysis. This is called Microscopic Hematuria. It is usually discovered when urine sample is tested. Usually there is nothing serious about it as long as its causes are identified and treated timely. Let’s learn more about what it is and what to do when you have blood in urine testing. Many times you may see that the entire urine is red, that is called gross hematuria and you can read more about that here.

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. In some situations you may feel pain in the region of the kidneys.


Some of the most common causes include:

  • Kidney infections: These can occur when bacteria enter your kidneys from your bloodstream or move from your ureters to your kidney(s). Signs and symptoms are often similar to bladder infections, though kidney infections are more likely to cause a fever and flank pain. Usually in patients, especially older adults, the only sign of illness might be microscopic blood detected in the urine.
  • Enlarged prostate: The prostate gland which is just below the bladder and surrounding the top part of the urine pipe called the urethra often enlarges as men approach middle age. It then compresses the urethra, partially blocking urine flow. Signs and symptoms of an enlarged prostate (benign prostatic hyperplasia, or BPH) include difficulty urinating, an urgent or persistent need to urinate, and either visible or microscopic blood in the urine. Infection of the prostate (prostatitis) can also cause the same signs and symptoms.
  • Urinary tract (bladder) infection: These occur when bacteria enter your body through the urethra and multiply in your bladder. Symptoms can include a persistent urge to urinate, pain and burning with urination, and extremely strong-smelling urine.
  • Swelling in the filtering system of the kidneys – Glomerulonephritis: Microscopic urinary bleeding is a common symptom of glomerulonephritis, an inflammation of the kidneys’ filtering system. Glomerulonephritis may be part of a systemic disease, such as diabetes, or it can occur on its own. Viral or strep infections, blood vessel diseases (vasculitis), and immune problems such as IgA nephropathy, which affects the small capillaries that filter blood in the kidneys (glomeruli), can trigger glomerulonephritis.
  • Stone in your bladder or in  kidney: The minerals in concentrated urine sometimes form crystals on the walls of your kidneys or bladder. Over time, the crystals can become small, hard stones. The stones are generally painless, so you probably won’t know you have them unless they cause a blockage or are being passed. Then there’s usually no mistaking the symptoms — kidney stones, especially, can cause excruciating pain. Bladder or kidney stones can also cause  microscopic bleeding.
  • A disease that runs in families, such as cystic kidney disease
  • Some medicines: Certain medicines such as  aspirin, penicillin, heparin, cyclophosphamide, and  phenazopyridine.
  • A blood disease, like sickle cell anemia: Sickle cell anemia — a hereditary defect of hemoglobin in red blood cells — causes blood in urine, both visible and microscopic hematuria.
  • Tumor in your urinary tract: Tumor is the main reason why we take blood in urine so seriously and investigate it thoroughly. A tumor may or may not be cancer but it needs proper detection and a series of tests.
  • 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 will test your urine 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. doctor will perform a physical exam to check for pain or tenderness in the bladder or kidney area. Men may be given a digital rectal exam to look for prostate problems. Women may have a pelvic exam to look for the source of red blood cells in the urine.

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. These may include:

  • Kidney ultrasound: Ultrasound uses sound waves to create a picture of the kidney’s structure.
  • Computed tomography (CT) scan: A CT, which is a special X-ray scan, can help identify bladder or kidney stones, tumors, and other abnormalities of the bladder, kidneys, and ureters.
  • Cystoscopy:This test involves the insertion of a small tube with a camera into the bladder through the urethra. Tissue samples may be obtained to check for the presence of abnormal or cancerous cells.
  • Kidney (renal) biopsy :A small tissue sample is removed from the kidney and examined under a microscope for signs of kidney disease.

How is Microscopic Blood in Urine Treated ?

If the cause of the blood in your urine is evident, the treatment is directed is managing that cause. For example, if the condition is caused by a urinary tract infection, it is treated with antibiotics. Treatment for kidney stones can include waiting for the stone to pass by itself, medication or surgery.

If you are found to have kidney or bladder cancer, your doctor may refer you to an oncologist or urologic surgeon. If the tumor is found early, the cancer often can be cured. There are a number of options for kidney and bladder cancer treatment, including surgery, chemotherapy and radiation.

If the doctor rules out any medical problem causing hematuria, you will not need treatment.

If you find blood in your urine, or your doctor tells you that you have microscopic hematuria, don’t panic, The good news is that with proper evaluation, your doctor can find out the cause and if needed, make sure you get the correct treatment right away.

Often if no worrisome cause is found some general measures can be helpful to treat the condition such as:

  • Drinking plenty of fluids.
  • Take a balanced diet.
  • Light exercises.
  • Managing your Blood pressure or sugar levels, if present.

If you are worries about blood coming in your urine we strongly recommend that you consult a Urocentre expert today and at least take the first step from your side. Most likely it may not be serious but you’ll feel better when your doctor says that after a thorough examination and testing.

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