Microhematuria

A health condition that causes microscopic traces of blood in the urine is called microhematuria (microscopic hematuria). It may occur due to multiple reasons, including vigorous activities, stones in the urinary system, and others. Most of the time, doctors identify microhematuria during routine testing rather than as a result of symptoms.

In other words, microscopic hematuria is a condition in which there are small amounts of blood in your urine. However, when you go to the bathroom, the urine often looks normal. According to the American Urological Association, this condition occurs when there are 3 or more red blood cells (RBCs) per high-powered field under the microscope.

What is Trace Lysed Blood in Urine?

However, trace lysed blood in the pee is a type of microhematuria. The term “trace” indicates a small amount of blood that cannot be seen with the naked eye, and “lysed blood” means that the walls of the red blood cells broke apart. However, in people with microscopic hematuria, the red blood cell walls remain intact.

Symptoms

While most people with microhematuria do not have symptoms, some of them may experience the following symptoms. Check some examples below:

Frequent urination (peeing more than usual)
Dysuria (burning or pain during urination)
Flank pain (pain that occurs on either side of the lower back, above the hips)
Fever
Foul-smelling urine
Abdominal (belly) pain

Do not hesitate to visit a doctor if you or your child has any of the symptoms listed above.

Causes

While the most common cause of microhematuria is urinary tract infections (UTIs), it may also occur due to the following health problems. Check some examples below:

Vigorous physical exercise
Stones in the urinary system (including ureteral stones, kidney stones, and bladder stones)
Chronic kidney disease (CKD)
Urethral strictures
Some types of cancer (such as bladder cancer, kidney cancer, and prostate cancer)
Benign prostatic hyperplasia or BPH (enlarged prostate gland)
Menstrual periods
Certain medicines – These include nonsteroidal anti-inflammatory drugs (NSAIDs), Penicillin (a type of antibiotic medicine), and anticoagulants (also known as blood-thinners)

Anyone may develop microhematuria, but people with any of the previous health problems are at increased risk. Moreover, microhematuria, as well as UTIs (the most common cause of microscopic hematuria), are not contagious. It means the condition cannot spread from one person to another.

How Often is Microhematuria a Sign of Cancer?

Approximately 3% of people who have microhematuria have a type of cancer. However, the risk of cancer depends on several factors, including the severity of microscopic hematuria, whether you smoke, and your age. For more details, discuss it with your physician.

What Are The Potential Complications of Microhematuria?

People who develop microscopic hematuria may also experience the following complications if they leave the condition untreated. For example:

Increased risk of cancer (including bladder, kidney, or prostate cancer)
Renal decline – For example, CKD (chronic kidney disease) or end-stage renal disease (ESRD).
Severe infection/obstruction – These include pyelonephritis (kidney infection), stones in the urinary system, and others.
Systemic disorders – Sometimes, people may develop blood-clotting disorders or sickle cell anemia.

The previous list does not contain all possible complications of microhematuria, but you can talk with your doctor about ways to reduce the risk or even prevent them.

How to Prevent Microhematuria?

Unfortunately, it is not always possible to prevent this condition, but doctors often recommend the following tips to reduce the risk. These include:

Stop smoking – If you have problems with smoking cessation, discuss it with your healthcare provider.
Never use NSAIDs without a doctor’s approval because they may lead to unpleasant outcomes (including microhematuria).
Limit or avoid exposure to radiation and certain chemicals. For example, Benzenes, aromatic amines, and hydrocarbons.
Drinking plenty of water may also reduce the risk of microhematuria, especially during physical exercise.

Diagnosis

Like many other health conditions, the diagnosis of microscopic hematuria begins with a physical examination to check for irregularities linked to the disease. Doctors may also ask some questions about your symptoms and medical history to get more clues about your disease. However, to confirm or rule out microhematuria, they often order one of the following tests. For example:

Urinalysis – This test involves a urine sample, which is sent to the laboratory for testing.
Urine culture – Usually, to diagnose a UTI, doctors perform this test.
Blood tests (including a complete blood count or CBC) – These tests are often done to check kidney function and diagnose chronic kidney disease.
Imaging tests – The following tests are used to get detailed images of the kidneys and nearby structures. Physicians usually perform a CT (computerized tomography) urogram or an MRI (magnetic resonance imaging) scan.
Cystoscopy – During this procedure, doctors will insert a small and flexible tube with a lighted camera on the end (cystoscope) into the urethra and then the urinary bladder to examine it.
Biopsy – In most cases, doctors use a needle to get a sample of the affected kidney for testing. Sometimes, they may also take a sample of the bladder or prostate for testing.

Treatment

Usually, physicians prescribe different treatments for people who develop microhematuria. Check below some examples:

Antibiotics – This group of medications is primarily used to treat bacterial infections.
Medicines to relax or stop the growth of the prostate gland – For example, Tamsulosin, Terazosin, Dixazosin, Finasteride, or Dutasteride.
Medicines to help you pass a stone from the urinary system (mostly, doctors prescribe Tamsulosin or Nifedipine)
NSAIDs to reduce inflammation, pain, and damage to the kidneys.
Dietary changes – Usually, physicians recommend reducing the amount of protein, salt, and potassium if you have microhematuria.
Surgery to remove the stones from the urinary system or prostate gland.

Frequently Asked Questions

When should I be worried about microscopic hematuria?

Usually, it depends on what exactly causes blood in the urine. However, in most cases, the prognosis for microhematuria is good because most causes go away on their own or are easily treated.

Can you live with microscopic blood in the urine?

While most people with microhematuria do not need treatment, some people need treatment because this condition may occur due to stones in the urinary system or a more serious disease.

What is the most common cause of microhematuria?

In most cases, people develop microscopic hematuria due to urinary tract infections (UTIs), but it may also happen due to other causes. For example, stones in the urinary system, swelling in the filtering system of the kidneys, cystic kidney disease, chronic kidney disease (CKD), sickle cell anemia, and others. Ask your healthcare provider if you have additional questions.