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Tests and diagnosis
By Mayo Clinic staffTo find a cause for urinary bleeding, the following tests and exams play a key role:
- Physical exam, which includes a discussion of your medical history.
- Urine tests. Even if your bleeding was first discovered through urine testing (urinalysis), you're likely to have another test to see if your urine still contains red blood cells. Hematuria that occurs just once usually doesn't need further evaluation. Urinalysis can also help determine if you have a urinary tract infection or are excreting minerals that cause kidney stones.
- Imaging tests. Most people with hematuria are likely to have an imaging test that provides detailed images of their internal organs. This might be a computerized tomography (CT) scan, which uses radiation and a powerful computer to create cross-sectional images of the inside of the body; magnetic resonance imaging (MRI), which uses a magnetic field and radio waves instead of X-rays to produce images; or an ultrasound exam. Ultrasound uses a combination of high-frequency sound waves and computer processing to view your kidneys and bladder.
- Cystoscopy. In this procedure, your doctor threads a narrow tube fitted with a miniature camera into your bladder to closely examine both the bladder and urethra.
In spite of testing, the cause of urinary bleeding may never be found. In that case, your doctor is likely to recommend regular follow-up tests, especially if you have risk factors for bladder cancer, such as smoking, exposure to environmental toxins and a history of radiation therapy.
References
- Gerber GS, et al. Evaluation of the urologic patient: History, physical examination, and urinalysis. Wein AJ, et al. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/151836479-3/0/1445/6.html?tocnode=54299533&fromURL=6.html#4-u1.0-B978-0-7216-0798-6..50005-4_96. Accessed Aug. 2, 2011.
- Rose BD, et al. Evaluation of hematuria in adults. http://www.uptodate.com/home/index.html. Accessed Aug. 1, 2011.
- Margulis V, et al. Assessment of hematuria. Medical Clinics of North America. 2011;95:153.
- Sandhu KS, et al. Gross and microscopic hematuria: Guidelines for obstetricians and gynecologists. Obstetrical and Gynecological Survey. 2009;64:39.
- Jimbo M. Evaluation and management of hematuria. Primary Care Clinics in Office Practice. 2010;37:461.
- McDonald MM, et al. Assessment of microscopic hematuria in adults. American Family Physician. 2006;73:1748.
- Mercieri A. Exercise-induced hematuria. http://www.uptodate.com/home/index.html. Accessed Aug. 1, 2011.
- Urinary tract infections: What you need to know. National Kidney & Urologic Diseases Information Clearinghouse. http://kidney.niddk.nih.gov/KUDiseases/pubs/uti_ES/index.aspx. Accessed Aug. 2, 2011.
- Hematuria (blood in the urine). National Kidney & Urologic Diseases Information Clearinghouse. http://kidney.niddk.nih.gov/KUDiseases/pubs/hematuria/. Accessed Aug. 2, 2011.
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