BLOOD IN URINE (HEMATURIA) | SYMPTOMS, CAUSES AND TREATMENT:

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)

WHAT ARE THE STAGES OF PASSING A KIDNEY STONE?

How to identify the pain of a kidney stone? | Symptoms of kidney stone!

Have you ever seen a patient having severe bursts of back pain or groin pain? Such type of pain may be a result of a twist of the cord to the testicle on its own due to which the testicle gets a reduced flow of blood and that thing results in intermittent pain which means repeated bursts of pain and relief. Some of the times it may cause vomiting and nausea. Furthermore, hernia also causes such pain. When the abdominal wall gets weak and bowels and fat makes their way through, it causes a hernia and that can cause extremely excruciating pain. It is highly uncomfortable for such patients. In such conditions, the patient should be rushed to the trauma center for a complete examination since in both the conditions of testicular twist or hernia there can be emergencies for medical procedures. However, in case the patient looks alright and without any fever, nausea, or vomiting, it may not be anything significant with him.

In case you have kidney stones you may experience one-sided pain in the abdomen. In some rare and uncommon cases, you may also feel pain in the groin or the genitals. A kidney stone ordinarily travels from the kidneys to the bladder through the ureters. During its journey through the ureter, the flow of urine either stops or reduces which is excruciatingly painful. Otherwise, it causes pain due to inflammation of the lining of those organs. 

What is the composition of kidney stones? | Causes of kidney stone!

Kidney stones are formed in your body due to so many reasons. For example, if you take food that contains too many salts, proteins, or oxalate-containing food like spinach or foods with green leaves you may be a dangerously open target to getting kidney stones. Very low water or fluid intake is the main reason for kidney stones. Ensuring to drink tons of water is quite supportive to prevent kidney stones. It can also be related to your family history or genetics.  A diet rich in Vitamin D may be another reason for these stones. If you have an ailment like gastrointestinal bypass surgery in the past such metabolic ailments can be highly risky to get these kidney stones. Anyway, kidney stones have a few compositions. One type of it comprises calcium and that is more common and widely known. The second type of stone contains uric acid. Furthermore, there are Cysteine stones. Certain hereditary abnormalities are responsible for such types of stones under which patients’ bodies are compelled to explicitly make cysteine stones. Also, people who suffer from repeated UTIs tend to form stones called struvite kidney stones.

Can someone pass a kidney stone?

The answer to the above is, yes! of course, they can. However, it is determined by the thickness and breadth of the stone whether someone can pass it or otherwise. Ordinarily, in nearly 80 % of cases, you can pass a kidney stone if the size of the stone is up to 4 millimeters. As long as the stone grows bigger say up to 6 millimeters in size the probability to pass it diminishes to nearly 20 %. The normal time a kidney stone is expelled out of the body by an ordinary patient is quite long and that is approximately one month. (chhanno com 11102021)

When to see a urologist for kidney stone pain? | Tteatment of kidney stone!

There are a couple of justifications to be considered for consulting a physician for an urgent intervention during the passing of a kidney stone. In case of agonizing pain that you cannot endure regardless of what oral medicines you are on that’s the reason for urgent intervention. Similarly, in case you suffer from high-grade fever again that’s the emergency because when the urine is being blocked by the kidney stone and you also suffer from UTI, it can make you get sick extremely fast. Furthermore, in case you are feeling nauseous or cannot eat anything, it’s one more reason for urgent intervention. But in case you feel alright and don’t have too much pain there’s nothing to worry about. Just allow the stone to be expelled by itself. During the time kidney stone is in the body or ureter, drink tons of water and other fluids since it will be helpful a lot. Some medicines like Flomax and Tamsulosin are also prescribed during that time since these can help loosen up the ureter muscles and expel the stone easily. 

Emergency interventions in case of infection.

During an emergency, your kidney stone treatment is not carried out simultaneously with some infection that is already active in your body. In such a case a stent is inserted in the ureter to link the kidney and bladder and assists to discharge the urine through that stent or tube. Alternatively, a tube called a nephrostomy tube is inserted in the kidney that passes through the back of the body and assists in discharging urine through that channel. It’s mainly subject to the intensity of your sickness as well as what is the size of the stone or which procedure is suitable for you. However, these are emergency interventions in case you are having an infection.  (chhanno com 11102021). 

Take care of your kidneys.

When kidney stones are passing through the ureter they can cause very excruciating pain. When they reach the bladder it’s normally not so painful. This is due to the reason that size of the ureter is smaller than the urethra. So anything that passes through the ureter can pass through the urethra more easily. Ordinarily, it’s not extremely painful when the kidney stone travels in the urethra but at times the pain can be highly excruciating. According to certain individuals, it is more critical than labor pain. Anyhow, kidney stone pain is truly agonizing and simply a shocking encounter to manage. Whenever these patients are in the emergency room they are so helpless and extremely miserable. So if it’s not too much trouble please take care of your kidneys as vigilantly as possible.

Thank you so much for reading this article and please take care everywhere and always. 

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(Updated on 24-12-2022)

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