Blood in urine in women: causes of pathology
The content of the article:
- Why does pathology arise?
- If there is blood in the urine - what does it mean?
- Which doctor should I go to?
The causes of blood in the urine in women can be various diseases and pathological conditions.
Blood in urine (hematuria) is a pathological condition in which the number of red blood cells in the urine exceeds the physiological norm.
Normally, there is no visible admixture of blood in the urine, and with microscopy, single erythrocytes can be detected, which come from the external genital organs in the case of their careful toilet. When, during the analysis of urine, blood is found in it, in 60% of cases this indicates a pathological process in any part of the urinary system.
The cause of blood in the urine in women is usually a urological pathology in which the kidneys, bladder and / or urinary tract are affected. In addition, blood in the urine appears in gynecological pathologies or diseases that are accompanied by increased activity of the blood coagulation system (hypercoagulation).
When the urine is stained with blood, it is called gross hematuria.
If blood in the urine is detected only by laboratory research, and the color of the urine is normal, this condition is called microhematuria. If the urine changes its color, becoming stained with secreted blood, and becomes cloudy, we are talking about gross hematuria.
Why does pathology arise?
The reasons for the appearance of blood in the urine are more often the following diseases and pathological conditions:
- cystitis;
- urethritis;
- urolithiasis disease;
- glomerulonephritis;
- endometriosis (bladder or other organs of the urinary system);
- neoplasms of the urinary system;
- sexually transmitted infections;
- idiopathic hematuria of pregnancy;
- kidney injury;
- damage to the urethra during medical procedures (cystoscopy, catheterization, etc.);
- foreign body in the urinary tract;
- taking certain medications (anticoagulants, combined oral contraceptives).
The appearance of an admixture of blood in the urine at the end of the urination process usually indicates that the source of bleeding is the bladder.
If blood is released from the urethra outside of the urination process, this indicates an injury to the walls of the urethra.
The staining of urine in a reddish color can also occur in the absence of a pathological process (and without admixture of blood in the urine) in the case of the use of certain drugs (some antibacterial drugs, nonsteroidal anti-inflammatory drugs) and the use of certain foods (beets, food colors). This condition is not hematuria.
If there is blood in the urine - what does it mean?
One of the most common causes is cystitis. This is an inflammation of the bladder, which can be acute or chronic. In addition to the admixture of blood in the urine, patients with cystitis usually complain of frequent (including false) urge to urinate, pain and pain during urination, as well as periodic or persistent pain in the lower abdomen.
Cystitis in women can develop due to an inflammatory process in other parts of the urinary system, gynecological pathologies, hypothermia, non-observance of personal hygiene rules, weakening of the immune system, frequent stress, poor nutrition, and also after rough defloration.
Hematuria caused by inflammatory diseases of the lower urinary tract, accompanied by painful urination
Urethritis is also a common cause of blood in the urine. Pathology is an inflammation of the wall of the urethra, which is caused by infectious agents. Urethritis is acute and chronic. Its main features include pain when urinating, mucopurulent discharge from the urethra. Admixture of blood with urethritis, as a rule, is found in all portions of urine. The disease develops against the background of narrowing of the lumen of the urethra, urolithiasis or injury to the walls of the urethra during medical procedures.
Endometriosis of the urinary system usually begins in the uterus and appendages, less often in the external genitals. In 90% of cases, bladder endometriosis is diagnosed. A tumor-like formation appears in the bladder membrane, which is morphologically similar to the inner mucous membrane of the uterus (endometrium), which is rejected during menstruation. Patients with endometriosis of the urinary system during menstruation may experience pain in the bladder and urinary disorders with the appearance of blood in the urine.
With endometriosis of the urinary tract, compression of the ureter and impaired outflow of urine are noted. At the same time, the pressure inside the renal pelvis increases and hematuria of the cyclic type occurs.
If the urine turns brown (the color of meat slops), this may indicate the development of glomerulonephritis. The appearance of blood is accompanied by a decrease in the amount of urine (oliguria), an increase in blood pressure, and edema. The presence of pain in the joints against the background of these symptoms makes it possible to suspect systemic lupus erythematosus, which accompanies kidney damage. The disappearance of macrohematuria in such patients indicates the achievement of remission, but microhematuria can persist for a long time.
Microhematuria refers to the signs of tubulointerstitial nephropathies, while blood in the urine can be determined for a long time in isolation or in combination with a decrease in the specific gravity of urine.
Common causes of extrarenal hematuria include stone formation and movement of the stone through the ureters, bladder, or urethra, which is accompanied by severe pain.
A complication of urolithiasis can be a kidney abscess, which is also accompanied by the appearance of blood in the urine. In addition, the body temperature rises, a headache, chills, tachycardia appear, and the general state of health sharply worsens. In the lumbar region, intense pain occurs, the patient is in pain when or tapping in the projection of the affected kidney (Pasternatsky's symptom).
In an infectious process in the genitourinary tract, the source of bleeding is usually the capillaries of the inflamed walls of the renal pelvis and the mouth of the ureters. In this case, patients may have both micro- and gross hematuria. In the course of laboratory tests, infectious agents are found in the urine that cause infectious inflammation.
Detected blood in the urine of women without pain or other clinical signs is a reason for immediate medical attention, as it may indicate a tumor process in the kidneys or bladder. The immediate cause in this case is damage to the blood vessel wall by the tumor. In elderly patients with microhematuria, renal cancer and other neoplasms of the urinary system are excluded first of all.
The combination of hematuria with deafness and a history of kidney disease may indicate in favor of Alport's syndrome (hereditary nephritis, accompanied by deafness and damage to the ocular analyzer).
Pregnant women normally have no blood in their urine. However, it happens that hematuria is found in urine samples, as a rule, not accompanied by any other pathological manifestations. The reasons for the development of hematuria in pregnant women are not completely clear, therefore it is called idiopathic.
Presumably, in the early stages of pregnancy, blood in the urine appears due to hormonal changes; in the future, hematuria may be caused by impaired blood supply to the kidneys, squeezing of the urinary system by the growing fetus, and increased intra-abdominal pressure.
Hematuria of pregnant women is not a harmless condition, it can lead to fetal hypoxia, placental insufficiency, premature termination of pregnancy, complications of childbirth. In addition, such patients have an increased risk of uterine bleeding in the postpartum period.
The cause of the appearance of blood in the urine of pregnant women is often not possible to detect, however, this condition requires close medical attention
The reason for the appearance of blood in the urine can be hypothermia or overheating of the body, excessive physical exertion, while we are talking about functional hematuria. So, microhematuria can develop after prolonged walking or long-distance running. Gross hematuria in healthy people is not detected.
The color of urine with gross hematuria varies from scarlet to brown. This is always a serious sign that may indicate a neoplasm of the parenchyma of the kidney, pelvis, bladder, as well as kidney tuberculosis, bladder ulcers, some parasitic diseases (schistosomiasis, etc.).
With gross hematuria, blood clots can be found in the urine, the shape of which depends on the localization of the pathological process. So, thin twisted clots, resembling worms, can indicate a neoplasm of the kidney, and shapeless clots - a tumor of the bladder.
Which doctor should I go to?
The appearance of blood in the urine always serves as a reason for immediate medical attention. Self-medication of hematuria is unacceptable, as well as delay, as it can have the most adverse health consequences. Hematuria should be addressed to a urologist or nephrologist, who will prescribe an examination, and then treatment, depending on the results obtained. Additionally, you may need to consult a gynecologist, venereologist, endocrinologist, surgeon.
To make a diagnosis, an examination is carried out, including physical, instrumental and laboratory methods.
Laboratory research, first of all, consists in conducting a general analysis of urine with sediment microscopy. Additional analyzes are aimed at identifying an infectious, oncological or other pathological process in the body. Laboratory diagnostics makes it possible to confirm or deny the renal origin of hematuria.
Hardware methods include cysto- and ureteroscopy, ultrasound of the urinary system, computed or magnetic resonance imaging, intravenous urography, etc.
If blood in the urine is combined with severe proteinuria and / or deterioration of renal function, a kidney biopsy may be required.
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Anna Aksenova Medical journalist About the author
Education: 2004-2007 "First Kiev Medical College" specialty "Laboratory Diagnostics".
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