Red blood cells (erythrocytes) are microscopic blood components vital for life. They transport oxygen from the lungs to tissues and organs, and carry carbon dioxide back to the lungs for exhalation. Normally, urine should not contain these cells.
Red Blood Cells in Urine
Hematuria is the presence of red blood cells in urine. It appears in two forms: gross hematuria and microscopic hematuria. Gross hematuria is visible, making urine appear pink, red, or tea-colored. Microscopic hematuria involves amounts of blood too small to be seen without magnification.
Interpreting a 3-10 Count
A count of 3 to 10 red blood cells per high power field (RBC/HPF) indicates microscopic hematuria. While a few RBCs can be present transiently, this range is generally not normal. Finding 3 or more RBCs per HPF is considered significant and warrants further investigation, as it can detect underlying medical issues.
Potential Causes of Microscopic Hematuria
Several factors can lead to the presence of 3-10 RBCs in urine, ranging from temporary and benign conditions to more serious health concerns. Strenuous physical activity, such as vigorous exercise, can sometimes cause transient microscopic hematuria. Urinary tract infections (UTIs) are a common cause, where bacteria irritate the urinary tract lining, leading to bleeding. Kidney stones or bladder stones, formed from crystallized substances in the urine, can also cause bleeding as they move through or irritate the urinary system.
In men, an enlarged prostate (benign prostatic hyperplasia or BPH) can lead to microscopic hematuria. Certain medications, including NSAIDs or blood thinners, may contribute to red blood cells in urine. Kidney diseases, such as glomerulonephritis, where the filtering units of the kidneys become inflamed, can also result in microscopic hematuria. Less common but more serious causes include kidney or bladder cancer, which, while rare, warrant medical evaluation.
Diagnosis and Follow-Up
When microscopic hematuria is detected, healthcare providers conduct further tests to identify the cause. Initial steps include urine tests, such as a urine culture for infection or cytology for cell abnormalities. Blood tests may also assess kidney function. Imaging studies, such as ultrasound or CT scans, visualize the urinary tract for stones, tumors, or structural issues.
In some cases, a cystoscopy, involving a flexible tube with a camera to examine the bladder, may be recommended. Consulting a healthcare professional for evaluation and management is important, even for a low count of red blood cells in urine.