Last week, I received an email from Agnes (not her real name), a regular reader. She writes:
“Dear doctor, I read your article on cervical cancer symptoms and I have been very concerned since. I spotted blood in my urine; I am worried it might be one of the signs of cervical cancer. What should I do?”
Now I assume that Agnes is one of those who at some point has been or is going through this challenge and she is probably fighting this and anxiety related to it. That’s why I have decided to write about possible causes of blood in the urine.
Seeing blood in your urine can cause anxiety. While in many instances there are non-cancerous symptoms, blood in the urine can also indicate a serious disorder.
Blood in the urine is medically known as hematuria, and it can happen to anyone regardless of gender or age. That’s why we always recommend to take hematuria very seriously and to make an appointment to see your doctor any time you notice blood in your urine, especially if it lasts for some days without any notifiable reason as it did to Agnes.
It’s understandable that some medication and some foods may temporarily cause red discolouration of the urine, however, blood in the urine looks distinctly different.
In hematuria, your kidneys or other parts of your urinary tract allow blood cells to leak into urine. And when this happens, the first thing that comes in people’s mind is either cancer or other sexually transmitted diseases; which is possible but rare!
Apart from just cancer and certain sexually transmitted diseases, this can commonly be caused by a number of problems. These are:
1. Urinary tract infection (UTI): UTI often occurs when bacteria enter your body through the urethra and begin to multiply in your bladder.
Symptoms can include a persistent urge to urinate, pain and burning sensation with urination, and extremely strong-smelling urine. For some people, especially older adults, the big sign of chronic UTI may be blood in the urine.
2. Bladder or kidney stones: The minerals in the concentrated urine sometimes precipitate out, forming crystals on the walls of your kidneys or bladder. Over time, the crystals can become small, hard stones.
The stones are generally painless and you probably won’t know you have them unless they cause a blockage or are being passed. Then, there is usually no mistaking the symptoms as kidney stones can cause excruciating pain.
Bladder or kidney stones can also cause bleeding and the only way for this bleeding to come out is through the urinary tract. Kidney stones often have no definite, single cause, although several factors may increase your risk for instance, poor water intake, use of certain medications, and family history of kidney and bladder stones.
3. Blood in the urine can also indicate that the prostate is enlarged. This is specifically for men.
Almost 50 per cent of people with an enlarged prostate, fail to catch its symptoms and they complain of blood in the urine before diagnosis.
The prostate gland, located just below the bladder and surrounding the top part of the urethra often begins growing as men approach middle age. When this gland enlarges, it compresses the urethra, partially blocking urine flow.
Signs and symptoms of enlarged prostate may include difficulty urinating, an urgent or persistent need to urinate as well as specks of blood in the urine. Infection of the prostate can cause all these symptoms too.
Men are also urged to seek prostate screenings if they persistently notice blood in the urine especially if they are middle aged or have a strong family history of prostate issues.
Kidney injury, some inherited disorders like sickle cell anaemia may also contribute to hematuria.
The author is the medical doctor based in Dar es Salaam.