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Blood in the UrineBlood in the urine, whether visible to the eye (gross hematuria) or only under a microscope (microscopic hematuria), is important because it is a risk factor for cancer of the bladder and kidney. In fact, 80% of patients with bladder cancer have blood in the urine as the first sign of the disease. There are many causes for blood in the urine other than cancer, such as urinary tract (bladder) infection or inflammation, urinary stones, benign enlargement of the prostate (Benign Prostatic Hyperplasia or BPH), and in the case of microscopic hematuria, inflammation of the filtering device (glomerulus) of the kidney (focal glomerulitis). Bleeding from the bladder can also occur in distance runners as a result of bladder irritation. It is important that blood in the urine be evaluated to be certain that it is not caused by a serious disease such as cancer. Bladder CancerBladder Cancer is the fourth most common cancer in the US and hematuria is the most common symptom. Cystoscopy is a key, essential step in the diagnosis of bladder cancer. When caught early, as is usually is, bladder cancer can be very effectively treated, first, by removing the tumor using a small scope inserted through the urethra, followed by medicine given in the bladder to lower the risk that the tumor will come back. When the tumor grows into the bladder wall it is generally necessary to remove the bladder. A "new bladder" can often be constructed using the bowel. If the tumor spreads, chemotherapy is used.Kidney CancerCancers of the kidney can also cause blood in the urine, but now they are found most often when Xrays of the abdomen are done for other reasons. When found incidentally that way, they are often small and curable. Depending on the size and location of the tumor it may be possible to remove only the tumor and a small margin of normal kidney. Larger tumors require removal of the entire kidney, but this can often be done laparoscopically. Laparoscopic surgery uses a small scope and thin dissecting instruments on "sticks," so the kidney can be removed with a very small incision.Evaluation for Blood in the Urine (Gross or Microscopic Hematuria)The standard evaluation or "work up" for hematuria includes an imaging study to evaluate the kidneys and ureters (the thin tubes that drain urine from the kidneys into to bladder), a visual examination of the bladder (cystoscopy) and a urine test such as a cytology (microscopic examination by specially-trained pathologists for cancer cells that can be seen using the Papanicolaou or "Pap-smear" stain. Generally all three tests are done, but the work up may be more limited if the risk of serious disease is very low and another explanation for the bleeding is likely...ContinueCystoscopy: What to ExpectCystoscopy is the direct visual inspection of the bladder. The procedure is usually painless and does not require anesthesia, but topical anesthesia using anesthetic gels can be used...Continue
Created: 3/15/2005
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Home | Meet Dr. Lamm | About Us | Common Questions | Office Visit | e-Consultation Cancer Information | Symptoms | Treatment & Prevention | Research | Forms | For Physicians BCG Oncology, PC | 16620 North 40th Street, Suite E | Phoenix, AZ 85032 | (602) 493-6626 Copyright © 2007 BCG Oncology, PC. All rights reserved. Medical content authored by Donald L. Lamm, M.D., unless otherwise noted. |
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The information available on and through the BCGOncology.com Web site is presented in summary form as a supplement to, and NOT a substitute for, the knowledge, skill, and judgment of qualified physicians and health care professionals. The information on BCGOncology.com has been obtained from sources believed to be accurate and reliable. However, BCG Oncology, PC makes no warranty as to the accuracy, reliability, or completeness of this information. Information accessed on or through BCGOncology.com is neither complete nor exhaustive and does not cover all disabilities, diseases, illnesses, and physical conditions or their management or treatment. Information accessed on and through BCGOncology.com is provided "AS IS" and without warranty, express or implied, including, but not limited to, any implied warranty of merchantability or of fitness for a particular purpose. View our terms of use for more information. Donald L. Lamm, MD is licensed to practice medicine in the state of Arizona, only. |