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Episode Info:

In this episode and the last we are talking about blood in the urine.


Blood in the urine is a common reason people will come to the urologist. I our last episode I talked about gross hematuria or visual blood in the urine, specifically as an indicator and sign that a patient may have bladder cancer, or a kidney stone, or kidney cancer or a host of other serious problems.


Visual blood in the urine is not something you can mistake for something else. When you have gross hematuria your urine is red, think cherry kool-aid or maybe tomato soup. Sometimes you will have clots. The clots can be vermiform, long and stringy like a worm.

Visible blood in the urine is not normal. Don’t ignore it.

But there is another form of blood in the urine, called microhematuria, that also should not be ignored.  You can’t see microhematuria; it is found on routine laboratory testing. Microhematuria is diagnosed when a urine dipstick test indicates that there is detectable blood on the chemical exam and then, under a microscope, a laboratory technician can see red blood cells in your urine.

Microhematuria can be just as significant as gross hematuria when it comes to what might be causing the problem. While gross hematuria shouts at you “Go see a doctor!”, microhematuria says it quietly, in a sinister voice “You might have a problem.”

Link to AUA guidelines:

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