Do you have invisible blood in your urine? (Microhematuria) Let's talk about this!

Sometimes you may have a very small amount of blood in your urine , but you may not even notice it. This is often discovered during a check-up or other test by a doctor. This is what we medically call ``Microhematuria''. So, shall we talk about this in a little more detail and simply? There is nothing to be afraid of, it is very important to be aware of this.

What exactly is ``Microhematuria''?

Simply put, `(Microhematuria)` means blood, that is, blood, in your urine. But the amount of blood in this is so small that you can't see it with your naked eye. You need a ``microscope`` to see it for yourself. The American Urological Association defines it as ``Microhematuria`` if there are three or more ``Red Blood Cells (RBCs)`` in a urine sample under a ``high-powered field`` of a microscope. Imagine, that small amount! That means blood in the urine is so small that it is not visible to the naked eye.

So what is 'Trace lysed blood' in urine?

'Trace lysed blood' is also a type of `(Microhematuria)`. 'Trace' means a very small amount, as mentioned earlier, too small to be seen without a microscope. 'Lysed blood' means that the cell walls of the red blood cells have been broken and destroyed . In normal `(Microhematuria)`, the walls of the red blood cells are not broken, but are fine and intact. There is a small technical difference between the two.

What are the symptoms of this condition (Microhematuria)?

Most of the time, people with this `(Microhematuria)` do not have any symptoms (that is, `asymptomatic`). That is, you can have this condition without feeling any difference or discomfort. It is usually discovered by chance when a doctor checks you annually or does other `routine tests`.

However, sometimes you may also have symptoms like these:

• Needing to urinate more often than usual (`frequent urination`).
• Pain or burning when urinating (dysuria).
• Pain on either side of your lower abdomen, just above your hips (where your kidneys are) (`flank pain`).
• Having a fever .
• Urine has a bad odor .

If you have one or more of these symptoms, it is wise to see a doctor.

Why is there blood in the urine like this? What are the causes?

There can be several reasons for `(Microhematuria)`. Let's look at the main ones:

• Urinary Tract Infections (UTIs): This is the most common cause. Inflammation of the urethra , frequent urinationThis can be accompanied by weight gain and lower abdominal pain. These infections can cause tiny wounds in the urinary tract and cause bleeding.
• Your monthly period (`menstruation`): During a woman's period, blood can mix with urine and show up in tests. That's why urine tests are usually not done during menstruation.
• Certain medications: Some medications you take, for example, nonsteroidal anti-inflammatory drugs (NSAIDs) (e.g., ibuprofen, diclofenac), antibiotics like penicillin, and anticoagulants (e.g., warfarin, aspirin), can also cause this.
• Vigorous exercise: This can happen to some people after doing strenuous exercise such as running or jumping. This usually gets better on its own after a few days.
• Enlarged prostate (Benign Prostatic Hyperplasia - BPH): This can especially affect men over the age of 50. The prostate is a small gland located below the bladder. When it becomes enlarged, it can press on the urethra and cause bleeding.
• Stones in your urinary system: These can be kidney stones, ureteral stones, or bladder stones. These stones can scratch the delicate walls of your urinary system and cause bleeding.
• Chronic Kidney Disease (CKD): This condition can occur when the kidneys are no longer able to filter blood properly, causing red blood cells to accumulate in the urine.
• Urethral strictures: If the urethra (the passage through which urine comes out) is narrowed somewhere, that can also be a cause.
• Certain types of cancer: Microhematuria can be seen as an early symptom in more serious conditions such as bladder cancer, kidney cancer, and prostate cancer. However, it is important to remember that not all microhematuria is cancer .

However, sometimes doctors may not be able to find a specific cause for this ``Microhematuria''. There are also cases like that.

How likely is ``Microhematuria'' to be a sign of cancer?

This is a concern for many people. When people with `(Microhematuria)` are tested, about 3 percent (3%) of them are found to have cancer. This means that if 100 people have `(Microhematuria),` about 3 of them could have cancer. However, your risk of developing cancer depends on several other factors. These factors include:

• Your age: This risk increases slightly as you get older.
• Severity of the condition `(Microhematuria)`:That means how many red blood cells are in the urine.
• Whether you are a smoker: Smoking is a major cause of bladder cancer.

So, don't be afraid of cancer just because you have ``Microhematuria''. But it's important to talk to a doctor and find out the exact cause.

Is this condition contagious?

No, `(Microhematuria)` is not a contagious disease. It is not transmitted from one person to another. `(Microhematuria)` is a common cause of `(UTIs)`, although ``Urinary Tract Infections (UTIs)`` are not usually sexually transmitted, but in some cases, sexual activity can increase the risk of infection.

Who can develop this `(Microhematuria)`?

Anyone can develop ``Microhematuria``. This condition can affect adults as well as children . Although the causes may vary, the condition is common to everyone.

How do doctors diagnose this? (Diagnosis)

First, the doctor will ask you about your health history and ask about your symptoms (if any). For example, they may ask questions like:

• Have you ever had blood in your urine ?
• Have you gained or lost weight recently?
• Do you smoke, vape, or use other tobacco products?
• What medications do you take? (including over-the-counter medications (OTC medications) and vitamins (supplements).
• Do you use drugs?
• Has anyone in your family ever had cancer, blood in the urine, or kidney disease?

If your doctor suspects that you have blood in your urine, he or she will order several special tests to confirm this condition (Microhematuria) and find the cause.

What tests are done to detect `(Microhematuria)`?

A doctor may perform the following tests to determine if you have microhematuria and find the cause:

• Urinalysis: A sample of your urine is taken and sent to a lab for testing. This is used to first check for red blood cells, how many there are, white blood cells, and bacteria.
• Urine culture: If a urine test suggests an infection, this can help determine whether a urinary tract infection (UTI) is present and, if so, what bacteria is causing it. The appropriate antibiotic can then be given.
• Blood tests: For example, a complete blood count (CBC) and serum creatinine. These can help determine if you have an underlying medical condition, such as chronic kidney disease (CKD), or anemia.
• Imaging tests:An ultrasound scan, a CT urogram, or an MRI scan may be done. These can give your doctor a detailed picture of your urinary system, such as your kidneys, bladder, and urethra. These can help check for things like stones, tumors, and cancer.
• Cystoscopy: In this procedure, the doctor inserts a thin, flexible tube (called a cystoscope, which has a camera and light at the end) into your urethra to examine the inside of your urethra and bladder. This can be a little uncomfortable, but it is usually done under local anesthesia. This allows the doctor to see things like small tumors, stones, and lesions inside your bladder.
• Biopsy: If a suspicious area is found during a cystoscopy or scan, the doctor will use a needle to remove a small sample of tissue from the affected organ (e.g., bladder, kidney, prostate) and examine it under a microscope. This can help to diagnose a specific condition, especially cancer.

Not all of these tests are done for everyone. Your doctor will decide which tests to do based on your condition, age, symptoms, and the results of other tests.

How is this treated?

The treatment for ``Microhematuria'' depends on the cause. Once the cause is found, the doctor will begin the appropriate treatment.

• If you have a urinary tract infection (UTI), you may be given antibiotics for a few days.
• If the prostate gland is enlarged (BPH), medications may be given to shrink it (e.g. tamsulosin, terazosin) or control its growth (e.g. finasteride, dutasteride).
• If there are stones in the urinary system, medications (e.g. tamsulosin, nifedipine) may be given to help them pass more easily . Some stones may require other treatments (such as lithotripsy) or surgery.
• If this is caused by certain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), which can damage the kidneys, the doctor may tell you to stop taking the medication or switch to another medication.
• You may be asked to make changes to your diet. For example, someone with chronic kidney disease (CKD) may be asked to eat less protein, salt, and potassium .
• Sometimes surgery may be necessary to remove stones, parts of the prostate, or something like cancer.

However, if tests cannot find any cause, you may not need any treatment.Your doctor may choose to follow a strategy called 'watchful waiting'. This means they will monitor your condition but will not treat you until your symptoms change. Or they may choose to do something called 'surveillance'. This means they will repeat tests like a urinalysis every few months.

Can the occurrence of `(Microhematuria)` be prevented?

Sometimes, it may not be possible to completely prevent `(Microhematuria)`, as some causes are beyond our control. However , drinking plenty of water, at least 2-3 liters per day, especially when exercising, can help a lot. This dilutes the urine and helps keep the urinary system clean.

Also, the following things can help reduce the risk of microhematuria:

• Quitting smoking completely. This is the root cause of many diseases, including bladder cancer.
• Use painkillers like NSAIDs only as directed by your doctor, and only when needed. It's not a good idea to take these regularly for every little thing.
• Avoiding exposure to radiation and certain chemicals such as benzenes, aromatic amines, and hydrocarbons (these are commonly found in jobs involving factories, paints, and rubber).

When should I be worried about ``Microhematuria''?

It really depends on what is causing your blood in your urine. But in general, people with ``Microhematuria'' have a better chance of getting better. Many causes get better without treatment, or with minimal treatment. Once a doctor confirms that you have ``Microhematuria'' and finds the cause, they can give you a good idea of ​​what to expect.

When should I see a doctor?

You won't know if you have microhematuria until you've been tested by a doctor. So, if you have symptoms that could be related to microhematuria (e.g., a change in your urination habits, burning when you urinate , fever, pain in your lower abdomen), you should definitely talk to a doctor. If your symptoms are more severe, such as a high fever or unbearable pain, it's best to go to an urgent care center right away.

If you have had ``Microhematuria'' before and now have visible blood in your urine (this is called ``Gross Hematuria''), see a doctor immediately.

What questions should I ask my doctor?

When you go to see a doctor, it's a good idea to ask questions like these to get a clear understanding of your condition:

• What tests do you recommend I do to detect this ``(Microhematuria)''?
• What is the reason why I have this `(Microhematuria)`?
• Do I need treatment? Or is observation enough?
• If treatment is needed, what kind of treatment do you recommend? Are there any side effects?
• Can I get this ``Microhematuria`` condition again? What should I do to prevent it?

In addition to these questions, don't be afraid to ask your doctor anything you have or are concerned about. The more informed you are about your illness, the better.

So, what are the most important things we need to remember from this story?

Okay, we've talked a lot about ``Microhematuria'' now. Finally, here are the most important things you need to remember:

• Microhematuria is the presence of small amounts of blood in your urine that are too small to be seen with the naked eye. It is often discovered incidentally, during another test.
• Most people with ``Microhematuria'' do not need any treatment. Treatment is only needed if something like a stone or a more serious condition is the cause. In many cases, the cause cannot be found, and in such cases, it is simply observed.
• There can be many causes for this. It can be anything from simple things like urinary tract infections (UTIs) to rare, more serious conditions like cancer. But don't worry, not all microhematuria is dangerous.
• If you have any unusual urinary symptoms (e.g., frequent urination , pain when urinating , visible blood in the urine), be sure to see a doctor.
• The doctor is the one who will find the exact cause and, if necessary, give you the best treatment. So don't self-medicate.

The most important thing is to pay attention to the changes in your body and seek medical advice when necessary. This way, many problems can be identified early and resolved before they become serious. Stay healthy!

` Blood in the urine, Microhematuria, Microhematuria, Urinary tract infection, Kidney disease, Urinalysis, Red blood cells