Patient's question:
What are the characteristics of hematuria in urinary system stones?Doctor's answer:
Differential Diagnosis of HematuriaWhen hematuria occurs at the beginning of urination but the later part of the urine is normal, it is usually indicative of urethral diseases. If normal urination occurs initially but hematuria appears near the end, it is often associated with cystitis or prostatic diseases. If the entire urine is bloody and the color is dark red, it is generally caused by kidney diseases, and hematuria rarely leads to shock. Hematuria is commonly seen in the following conditions:
1. Acute Glomerulonephritis: Hematuria accompanied by oliguria, proteinuria, edema, and hypertension. The patient usually had tonsillitis one week before the onset.
2. Pyelonephritis: Hematuria accompanied by dysuria, urinary urgency, urinary frequency, and loin pain, often with fever.
3. Urological Stones: Characterized by hematuria with renal colic or urinary obstruction, difficulty urinating, and dysuria.
4. Renal Tuberculosis: Over 90% of patients with renal tuberculosis have hematuria, with symptoms of urinary urgency, urinary frequency, and dysuria gradually worsening.
5. Kidney and Urinary Tract Injuries: Often associated with a history of abdominal or lumbar trauma, such as contusions, collisions, or falls.
6. Allergic Purpura: This condition presents with skin hemorrhagic spots, gastrointestinal bleeding, and joint pain. Hematuria may appear 2–4 weeks later.
7. Systemic Diseases: Deficiencies of vitamin C or vitamin K, as well as hematological disorders like leukemia or hemophilia, can cause hematuria.
8. Drug-Induced Hematuria: Certain medications can damage the kidneys and lead to hematuria, such as gentamicin, tetracycline, sulfonamides, kanamycin, etc.
9. Temporary Hematuria: Caused by insufficient fluid intake, which resolves quickly after increasing water intake to dilute the urine.