Microscopic hematuria: Is it threat?

آخر تحديث: 18 مايو 2026

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يعد فحص البول من الفحوصات البسيطة الأكثر شيوعًا في الفحوص الطبية، ويتم تضمينه دائمًا في برنامج الفحص الصحي. بيلة دموية مجهرية هي إحدى الحالات التي يمكن أن تكون نتيجة لفحص البول. اليوم سنناقش حول هذه القضية.

Microscopic hematuria is defined for at least 7 days presenting 3 red blood cells/HPF in 2 consecutive urine examination tests. Where the bloods coming from? And is it threat? That is the most and routinely questions that patients asked me while they are in my urology clinic. First of all, I’m going tell you that, it is fine! Don’t be worry! Mostly it won’t cause any serious problem. If that is a problem, you will see your urine very redness with your bare eyes, not invisible like this, but anyway, a positive red blood cell finding in urine examination, we must do a further investigation to ensure that everything is alright.

جميع أماكن النزيف المحتملة التي يمكن أن تؤدي إلى بيلة دموية مجهرية.

1. Contamination – most commonly the etiology is contamination during urine collection, for example incorrect mid-stream collection or testing during menstrual period
2. الكلى - حصوات الكلى أو كتلة الكلى أو عدوى الكلى أو أمراض الكلى غير الجراحية
3. الحالب – حجر الحالب، ورم الحالب
4. المثانة - حصوة المثانة، ورم المثانة, عدوى المثانة
5. Prostate (Men) – Prostate disease, prostate cancer, عدوى البروستاتا
6. مجرى البول - حصوة مجرى البول، عدوى مجرى البول

The proper methodology in order to make clear in term of etiology of the Microscopic hematuria is the accuracy imaging. CT scan is the definite imaging to answer this kind of problem. When we found the positive clue from CT scan, then we will follow the protocol on each suspicious diagnosis. In the other hand, if we found nothing, we can ensure the patient that the symptom is fine, and it required to have the annual simple urine examination is all. The recommendation from American Urology Association guideline in 2020, suggest that we can let go the patient free from the annual following up program if the urine examination turn to negative finding.

أي أسئلة، لا تتردد في مناقشة مع أنا.

If you have a positive urinalysis finding or microscopic hematuria from a health checkup and would like proper urological evaluation, Dr. Soarawee Weerasopone offers specialist consultations at Bangkok Hospital Headquarters. احجز استشارة.

Frequently Asked Questions about Microscopic Hematuria

What is microscopic hematuria?

Microscopic hematuria is defined as the presence of 3 or more red blood cells per high-power field (HPF) on at least 2 consecutive urine examinations. Unlike gross hematuria, the blood is not visible to the naked eye and is only detected through laboratory urinalysis, often during a routine health checkup.

Is microscopic hematuria dangerous?

In most cases, microscopic hematuria is not immediately dangerous. The most common cause is sample contamination during urine collection. However, it requires further evaluation to rule out more serious causes such as kidney stones, bladder tumors, or prostate disease, particularly in older patients or those with risk factors.

What are the possible causes of microscopic hematuria?

Possible sources of bleeding include the kidneys (stones, tumors, infection), ureters (stones, tumors), bladder (stones, cancer, infection), prostate in men (BPH, prostatitis, prostate cancer), and urethra (stones, infection). Contamination during urine collection is also a very common reason for a false-positive result.

What investigations are needed for microscopic hematuria?

A CT scan with contrast is the gold-standard imaging investigation for evaluating microscopic hematuria. It can identify stones, masses, or structural abnormalities throughout the urinary tract. If CT findings are negative, the AUA 2020 guideline recommends annual urine monitoring until results normalize.

When can a patient stop follow-up for microscopic hematuria?

According to the American Urological Association 2020 guidelines, patients with microscopic hematuria can be discharged from follow-up monitoring once their urine examination returns a negative result on repeated testing, provided no significant cause has been identified on imaging.

إخلاء المسؤولية: هذا المحتوى مكتوب ومراجع من قبل الدكتورة سواروي ويراباسون، أخصائية أمراض المسالك البولية المعتمدة في مستشفى بانكوك الرئيسي. الغرض منه تعليمي فقط ولا يشكل نصيحة طبية. استشر دائمًا أخصائي رعاية صحية مؤهل قبل البدء في أي علاج طبي.