The term hematuria means blood in the urine. This condition can occur for no obvious reason and often resolves itself within a matter of days, leaving no lasting effects and often no clues as to its origin. Painful hematuria is most likely a symptom of an underlying problem that needs to be addressed, and how it is managed will depend on the cause. The pain may be related to kidney or bladder stones, a urinary tract infection, cancer, or another condition, and the most important step in managing the pain is often to uncover the cause.
Kidney stones, or other types of stones in the urinary tract, can be extremely painful, and in many cases intense pain is the only symptom. If there is also blood in the urine, resulting in painful hematuria, the condition most likely requires a trip to the doctor to make sure that the problem isn’t serious. Blood in the urine by itself is not necessarily an indicator of a serious condition, but pain is often a signal that there is a problem that requires attention. You may not be able to do much for the kidney stones except wait for them to pass, but sometimes pain medication can help relieve the worst of the discomfort.
Painful hematuria can be caused by cancer in the urinary tract, possibly in the bladder, kidneys, or urethra. The possibility of cancer is one of the main reasons that painful hematuria should be evaluated by a physician if it doesn’t go away on its own within a relatively short period of time. Pain can be an indicator of a tumor pushing against nerves in the urinary tract or possibly blocking the flow of urine. A computerized tomography (CT) scan or magnetic resonance imaging (MRI) may be able to show the cause of the painful hematuria. If it is a mass of any kind, it may need to be surgically removed to relieve the pain.
When painful hematuria is caused by loin pain hematuria syndrome (LPHS), it may be possible to manage the pain in one of several ways. If the kidneys hurt and are passing blood into the urine due to an infection, taking antibiotics may resolve the problem. Sometimes the kidneys ache and blood will pass into the urine due to inadequate blood flow through the kidneys, in which case taking anticoagulants may be of help.
There may be no apparent reason for the presence of LPHS, and no easy answer as to how to manage the pain. Typically you will need to see a physician for medication that can make painful hematuria easier to live with by blocking some of the pain, but in many cases such drugs will cut down but not eliminate the pain. Don’t assume the first medicine you try will provide relief, since dealing with this type of chronic pain may require some trial and error in order to get the best pain management for your situation. Be persistent until you feel that you can manage your painful hematuria.