Hematuria: Diagnosis

Urinalysis is one of the most common ways to test for Hematuria. Even if you experience blood in the urine, a urologist will need to perform a urinalysis to check for either gross blood in the urine or more than 3 red blood cells per high power field under the microscope. The presence of bacteria would suggest a urinary tract infection. However, if the urinalysis findings show white and red cells with crystals, it might support a diagnosis of a stone. Clumps of cells (casts) and heavy protein content in the urine could suggest medical renal disease.

Other ways to diagnose hematuria are through imaging test such as CT Urogram. Prior to a CT scan you may need a blood test to check your kidney functions before receiving an IV Contrast. CT Urogram scans the abdomen and pelvis after the administration of IV contrast. The scan is done before and after the IV Contrast is added. An MRI of the abdomen and pelvis or retrograde pyelograms (placing up the ureters via a cystoscope) are substitutes for a CT urogram, but less commonly ordered.

Cystoscopy is a procedure that allows your doctor to examine the lining of your bladder and the tube that carries urine out of your body (urethra). A hollow tube (cystoscope) equipped with a camera is inserted into your urethra and slowly advanced into your bladder. Cystoscopy is an office-based procedure with a flexible scope to inspect the urethra and bladder. In men, it also permits a look at the prostatic urethra. This test can help identify urethral narrowing, prostate obstruction or prostate bleeding, and bladder tumors or inflammation.

There is a wide range of additional tests that can be requested based on results from urine, blood, and CT scans in the diagnosis and treatment of hematuria. PSA (prostate specific antigen) blood test – often done in men to screen for prostate cancer (which can occasionally cause hematuria). Blood and urine tests help to also identify and diagnosis kidney diseases and/or provide a referral to a nephrologist. MRI or CT angiography can be required for the diagnosis of rare disorders of blood vessels that bleed into the kidney such as arteriovenous fistulae, hemangiomas or aneurysms.