Non-hemolyzed blood in urine refers to the presence of intact red blood cells within a urine sample. When detected, it indicates that bleeding is occurring somewhere along the urinary tract, from the kidneys down to the urethra. This finding serves as an important signal that warrants further investigation to determine the underlying cause.
Understanding Hematuria
Hematuria is the medical term for blood in the urine. It is a common finding, and the amount of blood can vary widely. Hematuria can be broadly classified into two main types based on the state of the red blood cells: hemolyzed and non-hemolyzed.
Hemolyzed blood in urine means that the red blood cells have ruptured, releasing their hemoglobin content. This often points to systemic issues or problems that are not localized to a specific part of the urinary tract, such as certain kidney conditions or the effect of some medications. The presence of intact cells, conversely, often suggests a more localized source of bleeding within the urinary system, such as an infection or injury. This distinction helps guide healthcare providers in narrowing down the potential origin and nature of the bleeding.
Appearance and Detection
The presence of non-hemolyzed blood in urine may or may not be visible to the naked eye. When enough blood is present to change the urine’s color, it is called gross hematuria or macroscopic hematuria, and the urine might appear pink, red, or even a cola color.
However, often the amount of non-hemolyzed blood is too small to be seen without a microscope, a condition known as microscopic hematuria. In such cases, detection typically occurs through laboratory tests, specifically a urinalysis. A dipstick test can provide an initial indication of blood, but a microscopic examination of urine sediment is necessary to confirm the presence of intact red blood cells and differentiate them from other substances that might cause a positive dipstick result.
Potential Causes
The presence of non-hemolyzed blood in urine can stem from a variety of conditions affecting the urinary system. Urinary tract infections (UTIs) are a frequent cause, especially in women, where bacteria irritate the urinary tract lining, leading to bleeding. Kidney or bladder stones, which are hard mineral deposits, can also cause non-hemolyzed blood by irritating or damaging the lining of the urinary tract.
Kidney diseases, such as glomerulonephritis, involve inflammation of the kidney’s filtering units, which can allow intact red blood cells to leak into the urine. Polycystic kidney disease, an inherited condition causing cysts to grow in the kidneys, can also lead to hematuria. While less common, cancers of the bladder or kidney can present with non-hemolyzed blood in urine, particularly in individuals over 50 years old.
In men, an enlarged prostate (BPH) is a common cause, as the enlarged gland can press on the urethra and cause blood vessels to become damaged and bleed. Prostate infections (prostatitis) can also lead to similar symptoms. Trauma or injury to the kidneys or other parts of the urinary tract, such as from a fall or contact sports, can result in bleeding.
Strenuous exercise, particularly long-distance running, can temporarily cause exercise-induced hematuria. Certain medications, including blood thinners, can increase the likelihood of bleeding, leading to non-hemolyzed blood in the urine. Benign familial hematuria is a genetic condition characterized by persistent, often asymptomatic, microscopic hematuria.
When to Consult a Doctor
Any instance of visible blood in the urine, known as gross hematuria, should prompt an immediate consultation with a healthcare provider. Even if the bleeding is minor or resolves quickly, it is important to seek medical advice to determine the underlying cause.
For microscopic non-hemolyzed blood, which is not visible but detected through tests, medical evaluation is also recommended, especially if there are accompanying symptoms like pain, frequent urination, or fever. Providing your doctor with details about any other symptoms, recent activities, or medications can assist in the diagnostic process.