What is hematuria and what are its causes:
When there is blood in the urine, gross or microscopic, it is called hematuria and it has many reasons. Mainly blood comes from the kidneys, bladder or the tubes urine passes through and mixes in the urine. It may come out of the kidney parenchyma itself because of some kidney disease that is innate to the kidney and may cause bleeding. Its reason may be a tumor or stones in the kidney. Any type of defect in the ureters due to stones, an obstacle, cancer, or such things can also be a reason. Ureters are the tubes that drain the kidneys by carrying urine to the bladder. It can also be because of a lump or tumor or a stone in the bladder or some abnormality in the urethra which may have so many other reasons. It happens frequently due to prostate problems in male patients and possibly atrophy etc., in ladies. In hematuria, the bad stuff is required to be precluded first. During a check, we do not want to ignore things like a kidney stone or bladder stone and cancer in any case therefore we preclude such things first since those can eventually create bigger complications.
How hematuria is diagnosed:
When a patient comes to the hospital with a complaint of hematuria he or she has to undergo many tests. The first one is the CT Urogram in which the CAT scan of the pelvis and abdomen is done. Firstly kidneys are scanned to check whether any tumors are there. This scan is done with contrast as well as without contrast. The content draining from the kidneys is then scanned to check if there are any irregularities in the tubes called ureters. A partial bladder scan is also done since it is not completely visible on the CT scan. In male patients, the prostate is scanned for its size. CT scan of different organs that may be squeezing the bladder physically is also done. As the bladder is only partially visible on a CAT scan, therefore, its cystoscopy test is done and which means examining the inside of bladder walls with a very small camera through the urethra which is quite an effective method to look at bladder tumors. It’s done on priority to find out any possible bladder cancer. To preclude any infection a normal urine test as well as urine culture test is likewise done since it tells us additional details concerning ureters as some specific sorts of tissue cells could be detected through it and may help diagnose the real cause. Hematuria patients are normally sent for a checkup to a urologist but in case there is a doubt of some kidney disease he has to go to a nephrologist. (@ chhanno blogspot com 25102021)
What is nephroptosis:
Blood in the urine may also be due to nephroptosis which is a very uncommon situation that seldom happens. Nephroptosis is a downward misplacement of the kidney for 5 cm or more than its actual position when you stand up. It causes various painful indications viz., “Dietl’s crisis” which may cause a fierce, colicky, intermittent, flank pain on one side which is truly acute just like kidney pain when there’s a stone in the kidney. Other symptoms that a patient may suffer include vomiting, nausea, and chills. The pulse of the patients may also go fast. Their urine may decrease occasionally and it may contain blood or protein.
The blood in the urine in such cases has possibly certain reasons for example the renal vein may get tightly strained causing a little bleeding from the kidney itself or a blockage in the ureter may be the reason. Bleeding may also occur due to displacement and drop down of the kidney from its original position since it crimps the ureter. The patient with nephroptosis feels pain due to the obstruction in the crimped ureter. Stretching down of body tissues holding the kidney in place may also cause pain and uneasiness. Further, due to pressure on the artery of the kidney, the flow of blood toward the kidney decreases which results in pain.
Treatment of nephroptosis:
Such a condition is treated by securing the kidney up into its correct position. Historically this condition was treated conservatively by using abdominal binders called corsets and these were usually used on the right side by slim ladies. In seventy percent of events, it is used on the right side. Corsets were typically used by people in the early nineteenth century. It was the most ordinary medical procedure performed by urologists during the last years of the nineteenth millennium and afterward, it went obsolete. The treatment of this condition with corsets was not successful at all since this medical procedure was done quite ordinarily without a high degree of precision. It was performed for many symptoms that were not nephroptosis thus the post-procedure results were just unsatisfactory for patients since what was being treated was in oblivion and therefore it became obsolete.
Presently it’s incredibly uncommon however you must have a serious level of doubt. The diagnosis of this condition requires a scan in a sitting position as well as a lying position which is not done ordinarily. So whenever you come across such a situation you must want to get this type of scanning for analyzing it. In modern times it’s treated through laparoscopy which is quite a simple procedure in which a very small incision is made and patients have quite a speedy recovery as compared to the nineteenth-millennium era.
Alright, God bless you all. Stay safe everywhere and always.
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(Updated on 09-01-2023)
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