Blood during urination in women may be a manifestation of disease, as well as the result of natural processes not associated with a medical disorder. Detection of changes in urine, timely referral for medical consultation, a full examination helps establish the cause, determine the amount of necessary remedial measures. This, in turn, is able not only to affect the pathological process, but also prevent several dangerous complications.
The factors determining the allocation of blood with urine
Gross hematuria changes in urine color spotting, microhematuria does not affect the color of urine and is detectable only through microscopic studies
Gross hematuria means that the blood content of not less than 5 ml per 100 ml of urine, fewer are diagnosed with microhematuria.
The main reasons:
- urolithiasis (going via the urinary tract sand, or stone);
- the glomerulonephritis;
- cystitis, bladder endometriosis;
- the use of oral contraceptives;
- the period of menstruation and menstrual disorders;
- tumors of the urinary system;
- traumatic injuries of the organs of urination;
- diseases of the blood system and blood vessels.
Bleeding can be initially (initial hematuria), at the end (end), throughout urination (total). Identify these features with special studies, helping to establish the localization of the source. Initial hematuria is detected, the allocation of blood from the anterior part of the urethra. Terminal hematuria in women is possible with pathology of the urinary bladder. With the defeat of kidney and ureter hematuria is observed total. Separately it is necessary to diagnose the discharge of blood after urination. Occurs this condition, in most cases, when the injured urethra (urethra).
The evaluation of gross hematuria define her character (initial, terminal, total), degree of intensity, and the presence of clots – their shape, size, quantity
Bleeding in form of clots are formed due to damage of blood vessels. Long, thin clots indicate bleeding in the kidneys or upper urinary tract (pelvis, ureters). Their education is the gradual coagulation of the blood in her moving up the urinary tract. In the presence of the source in the bladder, the formation of the formless elements, resembling small pieces or thin films.
The clinical features of different diseases
In addition allocation of blood, it is important to identify all other manifestations of the disease. Inflammation of the end of the urinary tract (urethritis) in women are accompanied by a burning sensation when urinating. Cramps and pain during in urine output may appear as in urethritis and cystitis (inflammation of the bladder). If this pain can sharply increase at the end of urination in women.
Cystitis is one of the most common causes of urinating blood in women
For lesions of the renal parenchyma (glomerulonephritis, interstitial nephritis) painful urination are not typical. However, the patient can contact the doctor with pain or discomfort in the lower back, swelling, elevated blood pressure levels.
Most often the blood with urine in an unmodified form goes with the defeat bladder, various divisions of the urethra. A large number of modified red blood cells in the urine, which causes the color of “meat slops”, is typical of renal disease. It is necessary to differentiate neoplastic and inflammatory (glomerulonephritis) processes with lesions of the glomerular apparatus.
As well as blood in the urine may occur in pregnancy. It is necessary to distinguish between physiological, pathological factors of.
- hormonal changes, increased permeability of blood vessels;
- the pressure on the kidneys, urinary tract, uterus large size and weight (late-term);
- damage to the small blood vessels of the renal parenchyma due to increased intra-abdominal pressure (in third trimester).
These changes are observed during normal pregnancy and disappear after delivery. Pathological causes of blood in the urine of a pregnant woman are the same as outside of this period. Can be inflammatory (glomerulonephritis, pyelonephritis, cystitis, urethritis) and inflammation (neoplasms, diseases of blood vessels and circulatory system) character.
Features of diagnostic search
If you suspect a discharge of blood with urine, you must consult a doctor. The doctor must confirm the fact of hematuria, its character, to determine the cause. Depending on the pathological or physiological condition, a manifestation of which is the bloody discharge of urine, are developing approaches to further examination.
When collecting complaints need to be clarified for the patient visible color change, the presence of clots (size, shape). The period of the appearance of vaginal bleeding: during the whole urination, but only in the initial period or only at the end. Analyze data on the duration of these changes, the presence of other manifestations of the disease (fever, aches, weight changes, General weakness, rashes on the skin). A physician performed a direct examination of the patient, palpation of kidneys and a stomach, tapping in the lumbar region.
To determine the localization of the source is performed nervous system.. The first portion is about 50 ml, the second was 100 ml, the third – the remaining urine.
In addition to the urine, studies of blood (biochemical analysis), to identify inflammatory changes of any nature (infectious, neoplastic, immune).
The main instrumental examinations are:
- ultrasound of the kidneys and bladder;
- Ultrasound of internal genital organs (uterus and appendages);
- x-ray methods (excretory urography, review urography, computed tomography);
- magnetic resonance imaging;
- endoscopic examination (cystoscopy).
Pregnant women should first rule out kidney disease. The urinary system works in this period, with increased stress, can manifest the disease, which previously had a latent period. If necessary to go on consultation to the nephrologist. Further shows a joint with an Ob / GYN supervision, maintenance patients in this period.
Periodic survey of women in the period of carrying a child allow to identify even small amount of blood in the urine
These studies identify the possible sources of bleeding, in some cases its intensity. Depending on the underlying disease further examination is carried out under the supervision of a relevant specialist.
The presence of blood in the urine due to hormonal changes in a period of gradual cessation of menstruation or on a background of reception of contraceptives (i.e. natural causes) creates a need only observation and periodic surveys.
Approaches to therapy
After diagnosis medical management includes treatment of the underlying disease, and hematuria.
Conservative hematuria is treated by the application of styptic medicines.
- etamsylate (dicynone);
- aminocaproic acid;
The drug is prescribed by a doctor with individual selection of dose and regimen. Profuse bleeding treated in intensive therapy, long-term and small – scheduled medications.
If there is excessive bleeding and severe hematuria (trauma or tumor damage to major blood vessels), it is possible not only conservative therapy, and surgery.
A number of diseases complicated by hematuria (tumors, blockage of stones of the urinary tract), requires urgent surgical intervention
In children it is necessary to exclude hereditary disease and congenital defects that require special tactics of treatment.
At a pathology of kidneys (nephropathy, glomerulonephritis) therapy nephrologists. For kidney stones – urology. In this case, the possible surgical correction. In the presence of polevogo process shown specific cancer treatments. Vascular disease according to the type of vasculitis are treated under the supervision of a rheumatologists. Diseases of the hemopoietic system is supervised by hematologists.
Thus, the bleeding of urine in women is possible under different conditions: physiological and pathological. If you suspect that hematuria needs to see a doctor, be examined, including specialists narrow profile. Full compliance with all recommendations of doctors, effective methods of treatment (up to surgical correction) allow not only to stop the loss of red blood cells and related consequences, but also to prevent dangerous complications of diseases.