Consult Doc on Blood in the Urine
Q.: I do not have any pain, but I have blood in my urine. Could it be a cyst and where would the cyst be?
A.: There are many causes for blood in the urine (called “hematuria”) that is not accompanied by pain. Here are some possibilities:
Cancer is a possibility at any age, but especially if you are older and if you are a smoker. Tumors anywhere along the urinary tract (such as the kidneys, ureters, bladder, or prostate gland) may cause painless hematuria.
Kidney stones are possible: they cause severe pain if they are blocking urine flow, but non-blocking ones can also cause hematuria.
If you are southeast Asian, western European, Mediterranean, or southwest Native American in origin, you may be more susceptible to a kidney disease called IgA nephropathy, which may be associated with hematuria, especially during episodes of upper respiratory or GI viral infections.
As you mention, cysts and other types of benign growths and variants within the kidneys or bladder may cause hematuria, but uncommonly; even bladder inflammation (although it usually is painful) may rarely be associated with painless hematuria.
An inherited disease called “polycystic kidney disease” sometimes is associated with episodes of painless hematuria. In this disease the kidneys are normal at birth but gradually, over a period of several decades, become replaced by many cysts.
These are only a few of the many causes of blood in the urine. You should see your physician immediately, and have some preliminary tests including:
Urinalysis
Urine culture
Blood tests to see if kidney function is normal
Some sort of imaging study (usually an ultrasound)
When you see your doctor, it will be helpful if you can supply information such as:
How long you’ve had hematuria.
Whether there has ever been any pain (either in the bladder area or in the flank area) or burning associated with it.
Whether it’s there all the time or fluctuates in intensity.
Whether you’ve ever passed blood clots.
Whether anyone in your family has ever had kidney problems.
What kinds of medications you take (including over-the-counter meds, herbal meds, and illicit meds).
Whether you have any bleeding tendencies elsewhere (bleeding gums, easy bruising, etc.).
Today’s answer is by Mildred Lam, Associate Professor, Nephrology Division, MetroHealth Medical Center, School of Medicine, Case Western Reserve University.
NetWellness, a collaboration of the University of Cincinnati, Ohio State University and Case Western Reserve University, is a consumer health information Web site. You can ask your questions through the site, www.netwellness.org.
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