Be wary of signals from painless hematuria

If there is blood in the urine, this situation is really worrying.In many cases, hematuria may be harmless, but hematuria may also indicate serious diseases in the body.You can see blood in the naked eye called the naked eye hematuria.When the doctor checks urine, the red blood cells are called red blood cells under the microscope as under the hematuria under the microscope.No matter what hematuria, the cause of bleeding is needed. In particular, it is reminded that painless hematuria is reminded. This is more likely to occur in middle -aged and elderly people, which needs to be highly vigilant.

In the past two years, Mr. Zhang, who is over and rare, has repeatedly appeared in the past two years. He hematuria with frequent urination, urgency, and difficulty in urination. Prostate tumors are not high.Systemic inflammation and prostate hyperplasia was specially visited to the hospital’s urology specialist. After asking the doctor, the doctor was highly suspected of having urinary tract tumors. After enhanced CT and cystoscopy after admission, a more hidden bladder tumor was found.

True and false hematuria

Hematuria is divided into true and false, sometimes it is often too nervous of pseudo -hematuria, but the true hematuria ignores the disease itself.Some people think that red urine is hematuria. In fact, it is not exactly. Some patients who come to the clinic are because they consume some foods, such as red amaranth, dragon fruit and other foods, or take certain medicines, such asLifepine, Feinadine, methyl Dobaba, etc. will also lead to red urine. This type of red urine does not contain red blood cells, called "pseudo -hematuria".Generally, you can disappear after changing your diet or discontinued drugs. Pseudo -hematuria and true hematuria can be distinguished through routine urine examination.

For people who do not have special food and drug intake, people who repeatedly or continue to appear in red or brown urine need to be alert to real hematuria, especially painless real hematuria.Pain -free real hematuria often repeatedly occurs under treatment and intermittently occurs, but long -term existence, sometimes it is often ignored by patients, and then delay diagnosis and treatment.


Common causes of hematuria are inflammatory, that is, urinary tract infection, often accompanied by frequent urination, urgency, pain, and incompetent urination. Red blood cells and white blood cells will appear in the routine of urination.The second common cause is stones. Stones are often hematuria caused by ureteral stones or bladder stones and urethral stones. It is often accompanied by symptoms such as low back pain; bladder stones or urinary tract stones, urethral stones are accompanied by poor urination, urinary pain, and pain pain.Performance.The last common cause is tumors. Hemurustness caused by urinary tumors is often painless nourishing hematuria. It can be accompanied by blood clots. It is necessary to do B -ultrasound or even enhanced CT diagnosis.The urinary systems often cause painless tumors of the niarobe urine: bladder tumors, ureteral tumors, pyelone tumors, and renal tumors.Among them, the highest incidence is the bladder tumor.

Tumor warning

The early symptoms of bladder tumors have no feeling of painless hematuria. It is a unique signal of urinary abnormal urination of the bladder tumor. Almost every bladder tumor patient will appear, and about 85%of the bladder tumor patients will be diagnosed.If there is no pain of the naked and eye blood urine, the urinary tumor, especially the elderly, should pay more attention. Even if the number of hematuria is not much, it should be paid enough attention and the doctor should be visited in time.

Symptoms such as frequent urination and urgency also often appear in patients with bladder tumors. If tumor cells invade and grow in the bladder triangle area, the symptoms of bladder irritation such as frequent urination and urgency can occur early.

Men may be more likely to suffer from bladder tumors than women. The possible reason is that the physiological characteristics determine that men are susceptible to bladder tumors. Bladder tumors are mainly formed by the long -term retention of urine and the infringement of the bladder mucosa in the urine.The main cause of urine is difficult to urinate.Men’s urethra is relatively long and can store urine for a long time.Secondly, smoking is also an important factor in male susceptible to bladder tumors. In addition to lung cancer, smoking is the most easily induced in bladder tumors.Statistics show that the incidence of bladder tumors in smokers may be 7 times that of non -smokers.In addition, after men entering their age, the level ofrogen levels decrease, which can easily induce bladder tumors.

Decisive tumor

Through imaging examinations, such as urinary B -ultrasound and enhanced CT examinations all help to find urinary system tumors or prostate prostate. B -ultrasound is a non -invasive, low -cost, and easy -to -popular examination, which is very suitable for early screening.If the B -ultrasound or CT examination is highly suspected of having urinary tumors, the cycroscopy or ureteroscopy is needed to further clarify the source of hematuria (bladder, left and right ureter), the specific location, size, surface conditions, base conditions, and base conditions of the tumorAt the same time, the pathology can be obtained by biopsy or the necessary intra -cavity treatment.

The treatment of bladder tumors is currently based on surgical resection. Radiation therapy, chemotherapy, immunotherapy, etc. are used as an auxiliary measures or a means of preventing recurrence after tumor resection.

Ureding electroclices: For small -sized tumors, tumor electromotive surgery can be performed through urethra, and the unweerous tumor that is not infiltrated with the larger muscle can also be removed.

Chemotherapy: It is divided into two types: systemic chemotherapy and local chemotherapy. According to the specific conditions of the patient, the system of systemic chemotherapy is adopted by patients.In terms of local chemotherapy, chemotherapy is currently adopted in the bladder.

Daping of the bladder: For tumors that have infiltrated muscle layers but are more limited, this treatment can be used.

Bladder full -scale surgery: It is suitable for swelling and pain deep, wide range, or tumor in the triangle area. It is difficult to use the above surgical method, and the bladder should be used.There are many ways to diversion the urine flow after whole bladder resection, such as backbuilding bladder and new bladder in situ in situ.

In summary, once "hematuria" occurs, especially painless hematuria, after eliminating special foods or drugs, it should be paid great attention, especially those red or blood -like red or blood coagulation that can be washed and water -like in the appearance of urine.piece.Compared with symptomatic painful hematuria, painless hematuria, especially middle -aged and elderly people, need to cause us to be highly vigilant.

There are many causes of painless hematuria. Dedicists generally follow the principles of simplicity to complexity, from non -invasive to innovation, established and positioning.

Generally ask the medical history to understand whether there are special food and drug intake history, and do urine analysis and examination to eliminate possibility of pseudo -hematuria.If it is true hematuria, it is recommended to do further imaging tests, such as urinary ultrasound examination, CT or magnetic resonance, etc. If necessary, cycroscopy or ureteroscopy is performed.Middle -aged and elderly men also need to check the prostate specialty antigen (PSA) and anal finger tests to eliminate hematuria caused by prostate cancer.

Finally, remind everyone that painless hematuria needs to be highly vigilant. Please go to the hospital in time to avoid delaying the condition and miss the best treatment time.

Jiang Chen (Department of Urology, Renji Hospital affiliated to Shanghai Jiaotong University School of Medicine)

Author: Jiang Chen

Source: Xinmin Evening News

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