What should I do if I have blood in my urine?

Patients with hematuria cannot be treated blindly. First, the cause must be understood before solving the problem. Attention should be paid to excluding false hematuria and clarifying the site of hematuria. It is recommended to go to the hospital for examination so that the real cause can be understood and the correct treatment can be given.

1. Eliminate false hematuria

When hematuria is found, it should be determined whether it is true hematuria, that is, to rule out false hematuria and red urine caused by certain reasons. False hematuria: during urination, bleeding from parts other than the urinary tract (menstruation, uterus, vagina or anus) contaminates the urine; red urine: ① Pigment: eating certain foods or drugs (beetroot, amitraz, rifampicin, porphyrin, phenolphthalein, santolin, etc. When the above situations are ruled out and multiple tests show hematuria, it should be taken seriously and the diagnosis should be made through medical history, physical examination, laboratory examination and other auxiliary examinations.

2. Identify the site of hematuria

If urination starts with hematuria but the latter part of the urine is normal, it is usually a urinary tract disease.

If hematuria occurs at the end of the period, it is mostly caused by cystitis and prostate disease; if it is "hematuria throughout the whole process", the blood is dark red, which is generally caused by kidney disease. The three-cup urine test can help you understand the source of hematuria, and the method is very simple. Take 3 cups. During one urination, the first cup is for the front urine, the second cup is for the middle urine, and the third cup is for the back urine. If the first cup of urine is hematuria, it means the blood comes from the urethra; if the third ... is coming from the urethra; if the first cup of urine is bloody, it means the blood is coming from the urethra; if the third cup of urine is bloody, it means the blood is coming from the urethra; if the first cup of urine is blood

To clarify which disease causes hematuria, it is still necessary to conduct various tests, X-ray and CT examinations, or even kidney biopsy based on symptoms and physical signs to confirm the diagnosis.

3. Distinguish whether the hematuria comes from the renal parenchyma or the urinary tract:

If casts are found in urine sediment, especially red blood cell casts, it means that the bleeding comes from the renal parenchyma.

Proteinuria is almost always a sign of glomerular hematuria; if casts containing immunoglobulins are found in the urine, it is mostly renal parenchymal bleeding; in hematuria caused by glomerular diseases, the red blood cells are mostly deformed, with different shapes and sizes, while in non-glomerular hematuria, the red blood cells are mostly normal in size, with only a small number of deformed red blood cells. The etiology of non-glomerular hematuria is very complex, and one should be particularly alert to malignant tumors of the genitourinary system.