Myxedema

Present of blood in urine is called Haematuria. It may be idiopathic and/or benign.

TYPES
1. Microscopic haematuria : Presence of more than 5 RBCs per high power field (HPF) is considered significant and warrants further investigation.
2. Macroscopic haematuria : Red urine

CAUSES
1. Kidneys :-
- Renal calculus
- Renal tumours
- Renal injury
- Renal tuberculosis
- Renal infection
2. Ureter :-
- Calculus
- Neoplasm of the ureter
- Injury to the ureter
3. Urinary bladder :-
- Vesical calculus
- Vasical tumours
- Cystitis
- Trauma
- Bilharziasis (Schistoma haematobium infection)
4. Urethra :-
- Urethral injury
- Urethral calculus
5. Prostate gland (In Male) :-
- Prostatitis
- Benign hypertrophy of prostste
- Malignancy
6. Other causes :-
- Blood dyscrasiasis
- Anticoagulant therapy
- Sickel cell anaemia
- Drugs e.g. Rifampicin

INVESTIGATIONS
1. Urine R/M/E : RBC, WBC, malignant cells
2. X-ray KUB : Calculus, enlarged kidney
3. USG Abdomen
4. Blood Hb%, TC, DC, ESR
5. Cytoscopy : to visualized urethral and bladder pathology
6. Clotting profile : BT, CT, PT, Platelets

THREE TEST TUBE TEST
The patient is asked to pass the urine in the three test tubes. At the beginning, the urine is collected in the first test tube, the midstream in the second and the last stream in the third.
The collected samples are examined.
- Blood presence in the first test tube --- likely source is Urethra.
-  Blood presence in the third test tube --- likely source is Urinary bladder.
- Blood presence in the all test tube --- likely source is Ureters and Kidneys.

COMPLICATIONS
1. Massive bleeding : Hypovolaemic shock
2. Severe anaemia
3.  Retention of urine due to clot formation.