As the name implies, microscopic hematuria refers to an increase in red blood cells found only under the microscope and requires a routine urine test to detect. As the name suggests, microscopic hematuria refers to red, washed water-like urine, or even visible blood clots, usually visible to the naked eye when there is 1 ml of blood per liter of urine. Let’s learn more about carnal hematuria this time. After finding red urine, don’t panic, first review whether you have taken some special medications/foods, such as rifampin (anti-tuberculosis drug)/beets, etc., because urine will be red after taking these special medications/foods, but there are no red blood cells under microscopic observation, called pseudohematuria. After stopping these drugs/foods, the color of urine will naturally return to normal. For true hematuria, the following factors need to be considered: 1. Medication factors: The most common medications include bailey aspirin, poliovirus, and warfarin. As people’s living standards continue to improve and the population ages, the incidence of cardiovascular and cerebrovascular diseases (cerebral infarction and heart attack) is also increasing, and more and more people are taking long-term oral aspirin. For some patients with acute cerebral infarction and heart attack, they also need to take oral Bolivar for antiplatelet therapy at the same time. Patients with persistent atrial fibrillation and venous thrombosis require oral warfarin therapy. Undoubtedly, these drugs are effective in preventing thrombosis. However, there are two sides to the coin, and some patients may experience bleeding after taking these drugs, including: hematuria, bloody/black stool, vomiting blood, blood in sputum, bleeding gums, nasal bleeding, subcutaneous bleeding, and even cerebral bleeding (manifested by headache, hemiparesis, impaired consciousness, etc.). Therefore, once patients taking these drugs orally show bleeding manifestations such as hematuria, they should stop the drugs immediately, go to the hospital to check coagulation function and other related tests, and apply the corresponding antagonistic drug therapy if necessary. 2, urinary system diseases, the most common cause of hematuria, some patients only have hematuria, but no other accompanying symptoms. Including: (1) urinary tract infection: the most common cause of hematuria in life. Urinary tract infections are more common in women than in men because of the relatively short urethra and the proximity of the anus to the urethral opening, which makes it easy to get infected. After urinary tract infection, hematuria will appear, accompanied by fever, lower abdominal cramping, abdominal pain, increased frequency of urination, burning sensation in the urethra during urination, severe cases accompanied by chills, chills, back pain, and urine routine check suggests an increase in urine leukocytes, which requires antibiotic treatment. It is worth mentioning that patients need to drink a lot of water at the same time to increase urination for the purpose of flushing the urethra and promoting the discharge of bacteria. Do not intentionally reduce water intake to reduce urination because of painful urination, as this will only be counterproductive. For some patients with hematuria and persistent bladder irritation (urinary frequency, urgency, painful urination), if antibiotic treatment is not effective, tuberculosis infection should also be considered. (2) Urinary stones: Blood flows through the kidneys to produce urine, which passes through the kidneys, ureters, bladder, urethra, and finally out of the body. The production of stones in any part of this process can cause hematuria. Most patients have abdominal pain and lumbar pain. Ultrasound examination of the urinary system helps to detect stones, and drinking more water and bouncing help to expel small stones (diameter <6mm), while large stones can be removed by extracorporeal lithotripsy and surgery. (3) Urological tumors: Most of them are painless hematuria of the naked eye. Unlike hematuria caused by urinary tract infections and stones, most patients with hematuria caused by tumors do not have abdominal pain or back pain, so these patients need to have urinary system ultrasound or even cystoscopy for clear diagnosis. (4) Renal immune diseases: such as glomerulonephritis, nephrotic syndrome, etc. Patients mostly present with microscopic hematuria, but some patients can also present with carnal hematuria, which can be accompanied by proteinuria, lower limb/eyelid edema, hypertension and/or renal function impairment, etc. (5) Trauma: Trauma injury to the urinary system, such as renal contusion, can lead to hematuria. (3) Other: (1) Hematologic diseases: such as leukemia, myelodysplastic syndrome, thrombocytopenic purpura, etc. Patients have a significant decrease in the number of platelets in the blood, resulting in abnormal coagulation function, which can lead to hematuria. Blood routine, coagulation function, bone marrow aspiration/biopsy and other tests are needed to clarify the diagnosis. (2) Liver diseases: such as acute hepatitis, cirrhosis, drug-related liver damage, liver cancer, etc. The liver bears the function of synthesizing coagulation factors. Once the liver function is severely impaired, the synthesis of coagulation factors is impaired, which will lead to bleeding manifestations. (3) Tumors of other systems: rectal cancer, uterine tumors, etc., can involve the urinary system and cause hematuria. Hematuria can occur in the above three diseases, but hematuria is not the main manifestation of these three diseases, and most patients have other corresponding symptoms and signs. For example, patients with liver disease are often accompanied by nausea, loss of appetite, fatigue, yellowing of the skin, etc. Patients with rectal cancer are more likely to have bloody stools and changes in stool characteristics. (4) Sports hematuria: refers to the sudden appearance of transient hematuria in healthy people after strenuous exercise. It is related to excessive exercise intensity, rapid increase in exercise volume and decrease in physical function. It is mostly manifested as microscopic hematuria, and a few of them are flesh-eye hematuria, which is usually not accompanied by other abnormal symptoms and signs after exercise, but only fatigue and weakness. The hematuria disappears rapidly after the discontinuation of exercise, usually within 3 days, with a good prognosis and no effect on health. It is important to note that exercise hematuria is an exclusionary diagnosis, and the diagnosis can only be made if other pathological causes of hematuria are excluded and the course of the disease is consistent with exercise hematuria. Urinary system diseases are the most common and most frequent causes of hematuria. Once hematuria occurs, one should immediately stop the suspected drugs and at the same time observe whether one is accompanied by fever, abdominal pain, lumbago, edema, loss of appetite, weakness, other bleeding manifestations such as bloody stools/black stools, vomiting blood, blood in sputum, bleeding gums, nasal bleeding, subcutaneous bleeding, increased menstrual flow, etc. Seek prompt medical consultation and select the appropriate The diagnosis should be made based on the accompanying symptoms and signs, and the appropriate tests should be selected.