Hematuria (blood in the urine)
Introduction
Urinary lithiasis, or “urinary calculi”, refers to the formation of small crystals or stones in the urinary tract (kidney, ureter, bladder). These stones can be silent or become highly symptomatic when they move or obstruct the flow of urine.
Dr Dominique specializes in diagnosis, minimally invasive treatment and recurrence prevention in urology.
⚠️ If an attack of renal colic occurs, or blood appears in the urine, prompt consultation is recommended to avoid renal or infectious complications.
Symptoms and warning signs
Clinical signs may vary according to stone location and size. Here are the main reasons for consultation:
1️⃣ Severe back pain or renal colic
- Pain often comes on suddenly, in the form of renal colic, radiating to the groin, abdomen or even genitals.
- It is often paroxysmal, suggesting a "blockage" of urinary flow.
- Sometimes accompanied by nausea, vomiting or restlessness.
2️⃣ Blood in urine (hematuria)
- Rubbing or damaging the wall of the urinary tract by the stone can cause blood in the urine.
- Hematuria can be microscopic (visible only in the laboratory) or macroscopic (pinkish, reddish or brownish urine).
- In the absence of major pain, isolated hematuria should also be investigated.
- Malformations ou anomalies vasculaires
3️⃣ Imaging renal, ureteral or bladder calculi
- Imaging (non-injected CT scan, ultrasound, X-ray, depending on the case) may reveal the presence of stones in the kidney (renal calculi), ureter (ureteral calculi) or bladder (bladder calculi).
- The location is important in determining the treatment strategy.
- Pathologies rénales glomérulaires
Diagnosis
Diagnosis is based on a combination of clinical elements and paraclinical examinations:
Care and treatment
The choice of treatment depends on the size and location of the stone, kidney function, the presence of infection, pain and previous history.
Recurrence prevention
Prevention is an essential part of management in order to limit recurrence:
- Lithogenic metabolic panel: analysis of urine and blood to identify risk factors (hypercalciuria, hyperoxaluria, hyperuricosuria, inhibitor deficiency, etc.).
- Dietetic adaptation:
- Increased water consumption (≥ 1.5 to 2 L/d depending on tolerance)
- Moderation of salt intake
- Control of animal protein and dietary oxalate intakes according to context
- Adjusting calcium intake (to avoid both excess and deficiencies)
- Increased water consumption (≥ 1.5 to 2 L/d depending on tolerance)
- Prophylactic drug treatment depending on type of stone (thiazides, citrates, allopurinol, etc.).
- Regular monitoring: follow-up imaging, urological and metabolic monitoring.
Why consult a specialist urologist?
A consultation allows :
- To confirm the diagnosis and precisely locate the calculus(es)
- To choose the most suitable technique (the least invasive possible)
- To minimize the risk of complications (obstruction, infection, impaired renal function)
- To obtain a metabolic assessment and set up a personalized prevention strategy
Son objectif : sécuriser le diagnostic, traiter efficacement la cause et préserver la santé du système urinaire.
Do you suffer from urinary stones?
Requirements
How to prevent recurrence of urinary calculi?
In this video, I explain how to effectively reduce the risk of recurrence of urinary calculi. I share with you the essential habits to adopt on a daily basis, the mistakes to avoid and the importance of a metabolic assessment to understand the origin of your stones. My aim: to help you prevent a new attack and protect your kidney health for the long term.
Do you suffer from urinary stones?
Dr. Sébastien Dominique manages emergency lithiasis crises, as well as the follow-up of patients prone to kidney stones.
📍 Cabinet Urologie Paris Opéra – Paris 17ème
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