Elevated red blood cells in the urine of men: reasons for deviation from the norm in an adult, what can be dangerous, what treatment is prescribed

One of the most accurate diagnostic measures for some diseases is the examination of human urine. By deciphering it, the doctor can make a preliminary conclusion about the pathological state of the body and obtain information about existing deviations from the norm.

A complete picture of the condition of the male body will be shown by the presence of red blood cells, leukocytes and protein in urine. Urine can change its structure if there is infection or inflammation in the body.

So how many red blood cells should a man have in his urine, and what quantity will indicate the presence of the disease? This issue will be discussed below.

The number of red blood cells in urine in men

Deteriorating health and the approaching midlife crisis in men cause a constant change in the number of red blood cells. The norm of red blood cells in the age category 18-45 years is (4.2-5.6 * 10)12 per liter of blood. Moreover, this figure should not be inclined upward or downward. Before 18 and after 45 years, the norm deviates by 0.2 in each direction.

A change in indicators is considered an alarming sign. Repeated analysis is carried out for reliability. But in any case, you should contact a medical specialist, because changes in the number of red cells in the urine may be temporary. An increase in red blood cells may occur due to a decrease in immunity levels. Everything returns to normal after 2 days. If the high level of red blood cells in urine continues to persist, then you should immediately make an appointment with a doctor.

Types of hematuria

The appearance of blood in the urine (hemautria) is divided according to intensity, origin, clinical picture, and pathogenesis. The classification allows you to decide on further actions to identify the pathology that accompanies this symptom and prescribe treatment.

According to the degree of intensity, there are two main types of pathology:

Microhematuria. The appearance of urine is not changed, a small number of red blood cells can be detected using instruments.
Macrohematuria. Urine becomes brown, black or scarlet, sometimes blood is found in the form of separate streaks.

According to clinical manifestations:

isolated (without other manifestations);
combined with proteinuria;
with pain syndrome;
persistent (permanent);
transient;
essential (of unknown origin);
asymptomatic.

Carrying out a three-glass test allows you to determine the location of bleeding. Macrohematuria is divided into the following subtypes:

Initial. Found in the first portion. Its causes are injuries to the lower part of the urinary system. Damage to these organs as a result of invasive research.
Terminal. Red blood cells end up in the last portion. In this case, the source of blood loss is localized exclusively in the bladder due to damage to its walls by stones, ulcers, and tumors.
Total. Regardless of the beginning or end of urination, all urine contains blood, and the cause is kidney damage (pyelonephritis, necrosis of the papillae, other pathologies).

Depending on the type of red blood cells released, a type of hematuria is distinguished, which has diagnostic value:

Glomerular. In this case, red blood cells change their structure as they pass through the glomerular basement membrane. They differ from normal ones in size and do not contain hemoglobin.
Postglomerular. In this case, the red blood cells have a normal structure, since the source of blood loss is located below the kidney filters, and the cells do not have to pass through it.

Causes of pathology

The reason for a small deviation from the norm is considered abnormal and is of a very different nature:

Kidney cancer

lack of treatment for infectious diseases;
heart failure, which appeared due to the individual course of an infectious disease;
mononucleosis, which is diagnosed only in hospitals;
severe hemophilia, which prevents blood from clotting, causing the second to enter the urine;
a pathogenic process that occurs through stagnation of urine in the bladder, which leads to the proliferation of bacteria;
surgical interventions and trauma, due to which the inflammatory process began in the kidney area;
formation of polyps in the genitourinary system;
the development of bacterial inflammation that arose due to advanced cystitis;
kidney cancer and diseases of the genitourinary system;
blood in the discharge, which is often caused by bleeding in the urinary tract.

Increased red blood cells in urine with prostatitis

An increased level of red blood cells occurs with a disease in men such as prostatitis. But the figure does not jump the line: no more than 3 units.

If, during observation by a medical specialist, the figure increases, then additional studies are carried out. Cytology and urine culture are prescribed.

Active development of bacteria is observed when urine is inoculated. This process occurs as a result of bleeding and all sorts of complications. Cancer is detected by cytology. The diagnosis of prostatitis requires constant intervention from doctors, because the disease can develop into a cancerous tumor, which causes terrible pain. Red cells increase in number when:

Physiological reasons

The excess of red cells in the urinary secretions of men can also be considered a physiological reason. The red blood cell count increases when an adult male:

Excess of red cells in men's urinary secretions may occur due to stress

consumed a large dose of alcoholic beverages;
ate a lot of spicy or salty foods;
was in the sun for a long time and got sunstroke;
took a steam bath;
became interested in prolonged physical activity;
suffered severe stress.

Doctors wrote a whole treatise on the topic: “What can’t be done before tests?” It reveals all the reasons for erroneous analyzes. A patient who neglects the advice of doctors harms the results of the tests. A repeat experiment is ordered.

Three-glass method for determining the localization of inflammation

If an increased content of red blood cells is detected in urine, especially if there are a lot of white blood cells, a urine test is prescribed according to the three-glass principle. Considering that the norm for red blood cells in urine in men is up to 1, the approximate localization of the pathology is determined. An analysis is prescribed if a disease is suspected:

glomerulonephritis;
hemorrhagic, chronic cystitis;
pyelonephritis;
prostatitis;
prostate adenoma;
suspicion of a benign tumor and cancer in all organs of the system;
urethritis is acute and in remission;
viral prostatitis.

The analysis is taken in 3 containers - glasses per urination, sequentially.

At first, about 20% in the first glass.
The main amount of urine is 60-70% in the second container.
The remainder is in the third, approximately 15%.

Collection of analysis in 3 containers

After this, the amount in each glass is examined and a ratio is drawn up indicating the location of inflammation. For example, red blood cells 1 1 2 in the urine means that in the first two containers the readings are normal, in the third there is an increased content. Since the analysis is carried out after a deviation is detected, the ratio 1 1 1 - everything is normal, excluded

Red blood cells in urine 2 1 1 - initial hematuria, means that they came with the first portion of excreted fluid, inclusions of blood from the urethra and inflammation is localized precisely at the site of urine output, cystitis, inflammation of the urinary canal, injury from a stone or tumor of the urethra is possible.

Terminal hematuria - red blood cells in the urine 1 1 2 indicate that the disease is deep, and blood inclusions come out with the last drops, residues. This happens with prostatitis. It is inflammation of the prostate gland that is detected in this way, diseases:

stone in the urethral canal;
prostate tumor;
BPH – prostatic hyperplasia;
cervical cystitis.

Terminal hematuria may indicate a prostate tumor or BPH

For women, such indications are typical for cystitis and inflammation of the urethral canal. Also for pyelonephritis - inflammation, kidney failure, cervical polyp. It is possible that the ratio of red blood cells in the urine is 2 1 2 or 2 2 2; all three containers have a high content of red blood cells.

For men, red blood cells 2 1 2 in the urine mean simultaneous inflammation of the urethra and prostate. Typically, urethritis and prostatitis appear in most men after 65 years of age simultaneously with high blood pressure - hypertension. The rate of red blood cells in urine in middle-aged men jumps, according to a similar pattern after a heavy feast with alcoholic beverages, salted fish and beer. Baths and steam rooms without any measure lead to overheating and deterioration of the kidneys. They are forced to work under heavy loads, cleansing the body and removing fluid from it.

Red blood cells in the urine 1 2 1 indicate that inflammation is localized in the bladder in both women and men. The kidneys and urinary tract are working normally. Red blood cells in urine 1 2 2 indicate prostate and kidney disease. This is the location of the disease:

glomerulonephritis;
hydronephrosis of the kidney;
immune-inflammatory disease of the glomeruli;
prostatitis;
bladder tumor;
pyelonephritis.

Follow the doctor's recommendations and you will be able to pass the tests correctly

You can collect samples using the three-glass method at home. To do this, you need to purchase 3 containers for testing at the pharmacy, label them and deliver them to the laboratory within 2 hours. Urine must be fresh, otherwise the accuracy of the analysis is low. If prostatitis is suspected, the test is taken in the presence of a doctor. After filling the first two containers, the urologist quickly massages the prostate and then fills the 3rd container.

From the glasses, liquid from the very bottom, sediment, is taken for analysis. The tubes are placed in a special laboratory centrifuge and separated within 15 minutes. Then the contents of the tubes are quickly tipped onto glass, covered on top and examined under a microscope, counting the amount of visible blood components.

Changes in the composition of urine can occur with various diseases and help diagnose them, taking into account other symptoms. Women rarely undergo a three-glass test. For them, urine readings divided into 2 approximately equal parts - a two-glass sample - are sufficient.

What treatment is prescribed

Treatment is determined in relation to the diagnosis of a specific disease. If an increased level of red blood cells is observed due to an inflammatory-infectious disease, the doctor will prescribe a number of antibiotics for treatment. A common drug in this area is Amoxicillin.

Bleeding that occurs inside the patient’s body is neutralized exclusively in a hospital setting. Surgery is performed or hemostatic medications are taken. Healing instillation is carried out in cases of inflammation in the bladder.

Cancers and polyps are destroyed exclusively by surgery. Chemotherapy treatment is not excluded. Doctors prescribe antibacterial agents to people with cystitis. Urine that has stagnated in the bladder can be removed with a mild diuretic. Canephron is a universal drug for this disease.

Pathogenic processes cannot be seen with the naked eye, therefore, if there is any suspicion of pathology, urine should be tested. Men over 45 need to take careful care of their health and remember to visit a urologist.

Isolated microhematuria

Isolated microhematuria is a difficult condition to interpret, but is often discovered by chance during a regular preventive medical examination.

In this case, microhematuria can be repeated in each subsequent urine test of the patient (persistent), or disappear periodically (intermittent). In itself, such division of hematuria does not allow us to determine the localization of the pathological focus.

It is more informative to divide microhematuria into symptomatic and asymptomatic (that is, hematuria accompanied by symptoms and without any manifestations).

Criteria for isolated hematuria:

1 Urine red blood cells 3-5 in the subcutaneous region, without change in urine color in 2 consecutive urine tests;
2 Absence of any complaints from the patient;
3 Absence of obvious signs of somatic pathology;
4Proteinuria is absent or trace (the amount of protein in the urine ranges from 0.033-0.066 g/l).

Decoding the indicators of general urine analysis in adults

Establishing diagnosis

The number of red cells in urine can only be calculated through laboratory tests. A person notices changes in the color of urine when there is blood in it. The low blood content in urine explains its brownish tint. Blood lumps on underwear indicate cancer.

Kidney bleeding is diagnosed when the urine is scarlet in color. The diagnosis of hematuria is made when a burning sensation is added to the color of the urine. And hematuria, in turn, is caused by urolithiasis or infection.

An increase in red blood cells in the urine is often associated with a male disease - prostatitis. A pronounced symptom is a constant desire to go to the toilet, while the discharge will be scanty in quantity.

Modern research methods help to identify a specific diagnosis of a pathological condition: ultrasound, blood tests.

Causes of High Red Blood Cell Count

Red blood cells increase in a woman’s body in response to many diseases; for convenience, the reasons are divided according to the level of damage:

Renal - an increase in red blood cells may indicate damage to the kidney tissue in a woman.
The content of red blood cells in excreted urine increases as a result of postrenal causes, and the urinary organs suffer.
Somatic factors: an increase in red blood cells is an indirect sign of a disease not related to the kidneys.

Treatment

Treatment is always prescribed by a doctor. To begin with, treat the symptom of bloody discharge in the urine.

If the cause is hidden in internal bleeding, then the patient is usually prescribed hemostatic drugs. You should not delay the appearance of a high content of red blood cells, leukocytes and other elements and substances foreign to the composition of urine. It is also necessary to pay attention to the color of the urine.

Doctors warn that later treatment will be ineffective and sometimes even useless. An example of the transformation of a disease such as prostatitis into an oncological tumor should make men think about their male health.

When a diagnosis has been completed by a specialist and a pathology has been identified, the treatment process should begin immediately. After all, later treatment may not be necessary if the patient develops complications. Only surgery can help a sick man in such cases.

Urine collection rules

Urine analysis readings will be informative with proper preparation and urine collection. A special container is purchased at the pharmacy or a glass jar is prepared at home.

The dishes must be prepared in advance, washed, sterilized and dried. Do not wipe, especially inside.
The day before the test, you should not drink alcohol, overheat, or eat spicy, especially salty foods. It is not advisable to put too much physical strain on yourself. If your doctor has prescribed you to take medication regularly, you should tell your urologist about this.
Before donating, you need to wash your external genitalia with warm water without soap or gel so that excess secretions do not get into the tests.
For dinner, you should not eat spicy or heavily colored foods. Such as beets and carrots, garlic and beans. Avoid fatty fried meats.
In the morning before the test, it is advisable not to have breakfast. On an empty stomach, the indicators are more accurate, especially since the level of sugar, leukocytes, proteins and other substances in the urine is simultaneously determined. As a last resort, refrain from coffee, strong tea, and drinks with dyes.

Women should not be tested during their period. Natural bleeding will distort the readings.

Damage to the renal glomeruli

This type of hematuria can occur in any age group, but is most common in childhood, as well as among adults under 45 years of age. Among the most common reasons:

Proliferative diseases of the renal glomeruli - Berger's disease, post-streptococcal glomerulonephritis, Henoch-Schönlein purpura, systemic vasculitis, Goodpasture's syndrome, membranous nephropathy, SLE.

These diseases usually debut with nephrotic syndrome. The most common condition from this list is Berger's disease (IgA-associated nephritis). Berger's disease is manifested by hematuria and slight proteinuria, while other signs of nephrotic syndrome are mild. In some cases, a sign of proliferative glomerulonephritis is only the presence of isolated hematuria.

Non-proliferative diseases of the renal glomeruli - diabetic glomerulosclerosis, membranous nephropathy.

Severe proteinuria and severe nephrotic syndrome come first in these conditions, but microscopic hematuria also occurs.

Gross hematuria and the presence of red blood cell casts are not typical.

Familial diseases - thin basement membrane disease, Alport syndrome. One of the most well-known hereditary causes of hematuria is Alport syndrome.

At the onset, this syndrome manifests itself as isolated hematuria; years later, proteinuria appears. Associated symptoms include hearing loss and visual disturbances.

Another common cause of hereditary hematuria is thin basement membrane disease. This condition is very easy to miss because the glomeruli appear completely normal under microscopy, but electron microscopy is necessary to detect membrane depletion.