Bloody urine

Most people will observe the color of their urine when going to the toilet, because for normal people, their urine is usually transparent or light yellow. When urine appears in other colors, it is likely that there is a problem with the body's urinary system. Especially when the urine is blood red, people often become very afraid that they have some incurable disease. So what is going on when a person's urine is blood red?

Why is the urine red?

Normal fresh urine is light yellow in color because it contains a yellow pigment called urochrome. However, the color of urine can also be dark or light depending on the amount of water you drink. If you drink more water and urinate more, the proportion of urochrome in the urine will be smaller, and the color will be lighter; if you drink less water, the proportion of urochrome in the urine will be larger, and the color will appear yellow. If urine is left for some time, its color will become darker. This is because some of the urochrome in the urine has been oxidized into urochrome. The waste produced by the human body and the urine pigments excreted every day are generally relatively constant, so the color of urine will not change much. 96%-99% of urine is water, and most of the rest is waste, such as uric acid, creatinine, etc. The normal daily urine volume of a person is 1000-2000 ml, among which men have 1500-2000 ml and women have 1000-1500 ml. The urine is light yellow in color and transparent without any precipitation or turbidity. Freshly excreted urine has a special grassy aroma, but after being left for a long time, it develops an ammonia smell due to decomposition.

Red urine When the urine turns red, it is mostly because there are red blood cells in the urine, which is medically called hematuria.

The causes of hematuria are very complicated. There are hundreds of diseases that can cause hematuria, and it is not easy to diagnose correctly.

If hematuria is accompanied by nose bleeding, bleeding gums, or skin bleeding, it may be due to a systemic bleeding disease, such as thrombocytopenia, allergic purpura, hemophilia, or even leukemia. Hematuria is just a manifestation of systemic bleeding.

If hematuria is accompanied by fever, joint swelling and pain, skin lesions, and multiple organ damage, it may be a connective tissue disease (such as systemic lupus erythematosus, nodular arteritis, etc.).

If hematuria is accompanied by hypertension, edema, and proteinuria, it is mostly glomerulonephritis.

If hematuria is accompanied by dull pain in the waist and abdomen, urgency, frequency, and pain when urinating, it is mostly a urinary tract infection or tuberculosis.

If hematuria is accompanied by distension and pain in the lower back or abdominal cramps on one side, kidney or ureteral stones are most likely the cause, especially if the patient is in so much pain that he cannot move comfortably in bed, the cause is most likely ureteral stones.

If hematuria is accompanied by difficulty, strain, and dripping of urine, in elderly men, it is mostly due to prostate hypertrophy, while in middle-aged men, urethral stenosis, urethral stones, or bladder tumors should be considered.

Visible or significant microscopic hematuria in people over 50 years of age, whether male or female, suggests the presence of a urinary tract disease. In particular, sudden onset of painless hematuria is mostly a manifestation of tumor erosion of the urine excretion duct, causing rupture and bleeding. If there is any delay, the opportunity for effective treatment will be lost forever.

More than 75% of urinary tract tumors in the elderly are malignant lesions, especially renal cell carcinoma, papillary bladder carcinoma and renal pelvic transitional cell carcinoma. Their common feature is hematuria throughout the urination process.

Bleeding from renal tumors often stops naturally without any treatment, causing patients to mistakenly believe that they have recovered and stop seeking medical treatment. When visible hematuria occurs again after a few months or years, the cancer has reached an advanced stage and painful cell metastasis has often occurred around the diseased organ or further away.

Since renal bleeding is first discharged through the ureter, long blood clots are often formed when passing through the ureter; if there is bleeding from lesions in the bladder, the blood clots will be larger and irregular.

The interval between bleeding episodes of bladder tumor is shorter than that of kidney tumor, and the frequency of urination is slightly higher than normal. It is generally acknowledged by scholars at home and abroad that the incidence of bladder cancer is very high among heavy smokers, and we should be especially vigilant about painless hematuria in these elderly people.

After men are over 50 years old, the prostate will undergo varying degrees of hyperplasia, which affects the smooth flow of urine and leads to secondary infection and congestion of the bladder mucosa and prostate. It may also cause venous rupture and painless hematuria, which should be distinguished from bladder tumors.

Another common disease causing painless hematuria in elderly women is urethritis. Its characteristics are: less blood in the urine, and often accompanied by fresh blood stains on toilet paper; long-term history of chronic urethritis; poor urination, bifurcated urine stream, urethral burning discomfort; doctors can see purple-red granulation-like hyperplastic tissue located inside the external urethral opening with the naked eye, which is mostly spherical or hemispherical. This disease is a benign lesion and can be cured by electrosurgical resection, urethral dilation and anti-inflammatory treatment.

In addition, diseases such as Henoch-Schonlein purpura, epidemic hemorrhagic fever, and lesions of organs adjacent to the urinary system, such as the appendix, rectum, colon, uterus, and ovaries, can also cause hematuria.