Definition of carnal hematuria
Hematuria: When there is a certain amount of red blood cells in the urine, it is called hematuria. If red blood cells can only be found under the microscope, it is called “microscopic hematuria”; if blood is seen with the naked eye or in the form of washed water-like urine, it is called “carnal hematuria”. Generally, 1000ml of urine contains less than 1ml of blood, which cannot be recognized by the naked eye and is only slightly muddy, 2ml of blood is slightly red, and 4ml of blood has a clear blood color, and there are more than 3 red blood cells in each high magnification field by centrifugation.
Causes of hematuria
There are many causes of hematuria, which can be broadly classified into four categories according to the definition of carnal hematuria.
1, lesions of the urinary system itself.
Such as pyelonephritis, cystitis, renal tuberculosis, etc.; immune reactive disorders: such as glomerulonephritis, nephrotic syndrome, etc., urinary stones, such as ureteral and renal stones, etc., urological tumors: such as bladder cancer, kidney cancer, etc., trauma, renal infarction, renal prolapse, drugs and poisons (such as sulfonamides, gentamicin, kanamycin, carbon tetrachloride poisoning), etc. This hematuria is mainly caused by the rupture of renal blood vessels or increased permeability of capillary walls.
2, lesions of the adjacent organs of the urinary system.
Such as prostatitis, vesiculitis, acute tubitis, etc.; uterine or rectal tumors, etc. Most of this hematuria is the result of inflammation spreading to the urinary system and causing increased capillary permeability in the urinary tract system.
3.Systemic diseases.
Such as sepsis, acute bacterial endocarditis, leptospirosis, epidemic hemorrhagic fever and other infections; hematological diseases, systemic disorders such as leukemia, aplastic anemia, hemophilia, allergic purpura, thrombocytopenia; cardiovascular disorders and come to hematuria such as congestive heart failure, renal arteriosclerosis, connective tissue diseases such as systemic lupus erythematosus, polyarteritis nodosa, etc. According to clinical observation, carnal hematuria is most common in tumors, tuberculosis and stones of the urinary system. Patients encountering hematuria should be combined with clinical conditions to determine the site of bleeding and clarify the cause of bleeding.
4.Exercise hematuria.
It refers to the sudden appearance of transient hematuria after strenuous exercise in healthy people. It is closely related to excessive exercise intensity, rapid increase in exercise volume and decrease in physical function. No other abnormal changes or causes can be found by clinical examination, laboratory tests and special examinations. Exercise hematuria is mostly manifested as microscopic hematuria, and a small number of cases show carnal hematuria, which is usually not accompanied by other abnormal symptoms and signs after exercise, but only fatigue and weakness. After the suspension of exercise, the hematuria disappears rapidly, usually within 3 days, with good prognosis and no effect on health. The presence of exercise hematuria can be a sign of maladjustment to the exercise load or a decline in physical function.
The diagnosis and management of exercise hematuria is very important. In any case of post-exercise hematuria, careful consultation and examination should be performed. Transient hematuria can only be diagnosed as exercise hematuria after excluding pathological hematuria caused by systemic disorders, urinary tract lesions, and diseases of nearby organs of the urinary tract, and if it is consistent with the characteristics of exercise hematuria. Do not treat post-exercise induced hematuria with pathological changes as exercise hematuria and delay treatment.
Differential diagnosis of common diseases of hematuria
1.Renal tumor: Mostly seen in patients over 40 years old, it is painless throughout hematuria, and pain can occur when the blood clot passes through the ureter.
2, bladder tumor: it is characterized by painless full course intermittent carnite-based hematuria, accompanied by infection with bladder irritation symptoms.
3, renal tuberculosis: for terminal hematuria, with intractable bladder irritation symptoms.
4.Urological stones: characterized by the sequential appearance of colic and hematuria after labor. Hematuria should be distinguished from hemoglobinuria, in which no red blood cells or few red blood cells are seen microscopically, and a large number of red blood cells destroy hemolysis, and the color of urine is not red but soy sauce, but the occult blood test is positive.
5, sports hematuria: mostly seen in athletes and military personnel after high-intensity training.
Care and health care for patients with hematuria
1, hematuria is a serious symptom and the patient is extremely fearful. Comfort and explanation should be given to the patient, explaining that 1 to 3 ml of blood in 1000 ml of urine is carnal hematuria. Blood loss is not serious.
2, usually develop the habit of drinking more water.
3.Smoke less or do not smoke, eat less stimulating food. Avoid taking: fishy and spicy, aquatic products (shrimp, crab), chili, garlic, raw onion, cilantro, dog meat, horse meat, donkey meat.
4.Actively treat inflammation of the urinary system, stones and other diseases.
5.Protective health care in the production of dyes, rubber, plastic and other tools.
6, in ordinary life and work, can not often make the bladder highly filled. Feel the urge to urinate, that is, to go to urinate, in order to reduce the urine in the bladder to stay too long.
7, pay attention to the combination of work and rest, avoid strenuous exercise.
In short: if hematuria is found, early examination, diagnosis and timely treatment; if it is difficult to be diagnosed for a while, it should be reviewed regularly at the hospital.