HEALTH GIST: “BLOODY” URINE WITHOUT PAIN

Medically speaking, red-coloured urine is known as gross hematuria. Until proven otherwise, gross hematuria should be assumed to be cancerous.

The most common malignancy of the urinary tract is BLADDER CANCER. It is four times commoner in men. Smoking is the most important risk factor associated with more than half of the cases. Other risk factors include exposure to bladder irradiation, dye, rubber, textile material and parasitic infection- schistosomiasis.

Painless gross hematuria (“bloody” urine) is the most common symptom, occurring in over 80% of patients. Dysuria, frequency, urgency, lower abdominal pain and bone pain (if metastatic).

Digital rectal examination and bimanual palpation may reveal a pelvic mass in locally advanced disease.
There are four types of bladder cancer- papilloma, papillary urothelial neoplasm of low malignant potential, low grade urothelial carcinoma and high grade urogenital carcinoma.

INVESTIGATIONS
If your doctor is suspecting bladder cancer, he might request for the following investigations:

  1. Urinalysis
  2. Urine microscopy, culture and sensitivity test
  3. Abdominopelvic scan which may reveal bladder lesions in the form of intra-luminal filling defects.
  4. Cystoscopy: This is the diagnostic gold standard.
  5. Computed tomography urography
  6. MRI urography

TREATMENT
Options of treatment depends on the stage of the cancer. Specialist in this field of medicine are called urologists.

OTHER CAUSES OF BLOODY URINE

Schistosomiasis
Hemorrhagic cystitis
Prostate cancer
Advanced colorectal carcinoma infiltrating the bladder wall
Urinary tract infection

HOW TO PREVENT BLADDER CANCER

  1. Avoid smoking. Smoking is the most common risk factor.
  2. Reduce your exposure to dye.
  3. Minimize your exposure to textile materials.
  4. Pay attention to change in your bowel habit. As change in bowel habit for a long period of time is often associated with colorectal cancer which in advanced stage can cause bladder infiltration leading to bloody urine.
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