Microscopic hematuria is when maybe a doctor told you that you have blood in your urine, but you couldn’t see it in the toilet. It’s often found on a microscopic exam where they check the urine and they see red blood cells. Gross hematuria is different. It’s when you actually see blood in the toilet.

Now, if you have microscopic hematuria or gross hematuria, you should be evaluated by a urologist. The American Urological Association has come out with new guidelines for the management of microscopic hematuria. Now, when we talk about blood in the urine, we wanna make sure there’s no urinary tract infection or kidney stones causing the blood in the urine. This is really for asymptomatic patients, meaning there’s no identifiable cause for the blood in the urine. For people who there’s no clear cause for blood in the urine, it should be worked up. And what the American Urological Association guidelines say, is that low risk patients now don’t require a CAT scan, which gets radiation, or a formal cystoscopy, which is placing a camera into the bladder to formally check for bladder tumors.

But we know now is that based on your age, your gender, as well as your history, those can risk-stratify you into low, intermediate and high risk patients. Now, if you’re a low risk patient, maybe you don’t need a cystoscopy or maybe you don’t need a formal CAT scan. It’s really based on individual risk factors. However, if you’re a high risk patient, you may require further workup or more extensive workup, such as a CAT scan or a formal scope in the bladder to evaluate for bladder tumors. Now, many things cause microscopic hematuria and gross hematuria. What you need to understand is that there are many benign conditions, meaning non-malignant or non-cancerous conditions that can cause blood in the urine. Kidney stones can cause blood in the urine. Urinary tract infections can cause blood in the urine. An enlarged prostate can cause blood in the urine. So, don’t freak out yet if you have blood in the urine.

What you need to do is have a formal conversation with a urologist so we can evaluate your risk factors, clear anything in your mind and make sure that we get the correct diagnosis. So, if you have blood in your urine, I’d like you to call and make an appointment with me at Northwoods Urology of Texas, or visit me on the website to learn more. Thank you for listening. And I look forward to meeting you in the clinic.