What should you do if your urine is red in color?

Urine of a changed shade as a symptom in a clinical sense is not considered an indicative and obvious sign of a specific disease. Diagnosis of red urine is a rather complex process that requires multiple research methods, medical knowledge and practical experience. The general scheme, which is assumed by a set of diagnostic measures, is as follows:

1. Interviewing the patient, collecting anamnesis morbi (information about symptoms), anamnesis vitae (information about lifestyle, previous illnesses), and possibly family information - heteroanamnesis. The patient may be asked questions:

• When and under what conditions did a person first notice a change in the color of urine?
• Are there any accompanying symptoms - pain in the lower back, abdomen, urinary problems, spasms, nausea?
• When blood appears in the urine - at the beginning of the act of urination, throughout the act, or at the end (initial, terminal, or total hematuria).
• Have you had any previous urological or nephrological surgeries?
• Were there any physical strains?
• What medications does (did) the person take?
• Hereditary diseases.
• Was there a possibility of getting infected while traveling?
• The presence or absence of back injuries. Were there any blows or bruises?

1. Physical examination:

• Measuring body temperature and blood pressure.
• Inspection (examination) of the body (skin, mucous membranes), detection of enlarged lymph nodes, edema, possible traces of hemorrhage on the skin, petechiae.
• Palpation, percussion of the abdominal area. If indicated - palpation of the prostate.

1. Laboratory tests of urine, blood, and possibly feces.
2. Instrumental diagnostic methods.

Diagnosis of red urine (hematuria) is based on a set of analytical data. The most difficult is to clarify the cause of asymptomatic hematuria, in which the urine is not clearly colored, and red blood cells are detected only in laboratory tests (microhematuria). In such cases, a nephrologist, urologist, and possibly a hematologist are involved in the research, who specify the vector of searching for an accurate diagnosis.

Conducting analyses

If the patient complains of a change in the color of urine, the doctor, after physical examination and collection of anamnestic information, prescribes tests:

• OAM (general urine analysis).
• Quantitative determination and analysis of urine sediment, analysis by the Nechiporenko method (detection of the level of leukocytes, RBC (erythrocytes), hyaline cylinders. This analysis is also called a three-glass urine test.
• Quantitative method, collection of daily urine, Kakovsky-Addis test.
• OAC (general, clinical blood test).
• Blood culture.
• ESR analysis.
• Urine culture (antibiotic test).
• Biochemical blood test.
• Laboratory blood test for ASL-O (determination of antistreptolysin titer).
• According to indications, functional renal tests may be prescribed - ureteral catheterization.
• Blood test to study vascular-platelet hemostasis disorders.
• A convenient method of urine testing using chemical contrast test strips is often used to detect glucose levels, evaluate pH, and detect protein, bilirubin, ketones, nitrites, leukocytes, and blood elements. If the test shows the presence of blood in the urine, the result is interpreted depending on the color spectrum and may indicate hemoglobinuria, hematuria, or myoglobinuria.

The tests are supported by other types of diagnostics – physical and instrumental methods. It is important for the doctor and the patient to identify the cause of hematuria as quickly as possible, begin treatment and prevent complications.

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Instrumental diagnostics

Red urine as a symptom is considered to be quite alarming if the urine is not colored with phytopigments or changes color after taking medications. Hematuria requires immediate examination of the patient to identify the cause of the clinical sign and localization of the pathological process. After collecting anamnesis, physical examinations, laboratory tests of blood and urine, the patient is shown instrumental diagnostics. The methods of instrumental research that are widely used in urological practice are as follows:

• Urography (CT or MRI) to provide more specific information about the condition of the urinary system as a whole (bladder, ureters); the kidneys are also examined during the procedure.
• X-ray of the abdominal organs helps to clarify the presence or absence of stones in the kidneys and bladder.
• If the X-ray is uninformative, renal angiography is indicated. The method involves the use of a contrast agent that helps to clarify the condition of the tissues and vessels (arteries) of the kidneys.
• Intravenous Pyelogram, pyelogram – visualization of the condition of the kidneys, bladder, ureter. The procedure is performed using intravenous administration of iodine-containing medicinal contrast.
• An ultrasound examination of the abdominal organs is mandatory, a method that determines the general condition of vital organs. The emphasis is on the examination of the kidneys, ultrasound of the lower urinary tract is not effective due to the anatomical features of this area.
• Cystoscopy may also be prescribed – an invasive, endoscopic procedure that examines the condition of the internal tissues of the bladder cavity (tunica mucosa). In addition to cystoscopy, the list of endoscopic urological methods of instrumental diagnostics includes urethroscopy.
• If the clinical picture indicates glomerulonephritis, the patient is shown a morphological examination of kidney tissue (percutaneous biopsy).

Based on laboratory analysis of urine, information provided by instrumental diagnostics, and clinical features of the process, the doctor can begin to differentiate possible causes of hematuria, then make an accurate diagnosis and begin effective therapy for the identified pathology.

Differential diagnostics

Red urine is not always a symptom of a disease. Differential diagnostics primarily involves excluding physiological and transient, non-pathological causes of urine color change - food plant pigments (anthocyanins, porphyrins), taking specific medications or physical overexertion.

Red urine, which is preliminarily identified as hematuria and is already clinically interpreted as a possible sign of disease, must be differentiated from the following conditions:

• Trauma, bruise of the back in the kidney area.
• "Food" false hematuria (plant pigments in food)
• "March" hematuria - physical overload.
• Diseases of the hematopoietic system.
• Cystitis associated with radiation therapy for cancer.
• Urethral prolapse (UP) – prolapse of the urethral mucosa.
• Urethrorrhagia.
• Hemoglobinuria.
• Myoglobinuria.
• Drug-induced hematuria.

The most likely etiological factors of true hematuria are:

• Inflammation of the urinary system (cystitis, prostatitis, urethritis).
• Pyelonephritis.
• Stones in the ureter, bladder, kidneys.
• Vascular system pathologies – renal infarction, vena renalis (renal vein) thrombosis.
• Oncologic process – cancer of the ureter, vesica urinaria (bladder), prostata (prostate gland).
• Infectious diseases – endocarditis, tuberculosis.
• Glomerulonephritis.
• Necrosis of the papillae renales (renal papillae).
• Systemic vasculitis.
• Cyst (polycystic) of the kidney.
• Interstitial nephritis.

Differential diagnostics is not based on one symptom - red urine; extensive analytical information is needed to establish a correct diagnosis. Therefore, a patient with complaints of a change in the color of urine, with accompanying symptoms, must undergo a whole range of examinations, including blood and urine tests, instrumental studies. The faster the diagnostic measures are carried out, the faster and more effective the treatment process of the identified nosology will be.

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Treatment of diseases that cause red urine

Urine of red shades as a condition associated with physical overexertion or the presence of products with plant pigments in the diet does not require emergency care, as well as therapeutic efforts in principle. Treatment of red urine is the identification of the etiological factor that provokes the appearance of erythrocytes in the urine, treatment of the diagnosed pathology. Thus, the first thing to do is to differentiate the symptoms, diagnose the underlying cause of hematuria.

Features that treatment of red urine involves:

• Outpatient treatment is carried out only in cases where hematuria as a clinical symptom indicates blood loss (this is determined in the laboratory using tests).
• Stopping bleeding requires the administration of hemostatic drugs according to the clinical picture of the patient's condition and on the basis of the information obtained after the cito-examination.
• According to indications, blood substitutes (infusion therapy) may be prescribed.
• Short-term hematuria does not require drug therapy, patients with a single detection of red urine are under the supervision of a doctor, often remotely. If necessary, the patient seeks help if a portion of red urine is released again, further management and the choice of therapy depend on the accompanying symptoms and the general condition of the patient.
• Patients with macrohematuria are subject to hospitalization, often on an emergency basis, where they are under the supervision of the attending and duty physician, undergo a full range of diagnostic examinations and receive a course of treatment adequate to the identified pathological cause.
• Severe forms of hematuria (total, with blood clots in the urine) are treated with medications and catheterization (rinsing, emptying the urethra). If catheter insertion is impossible for objective reasons (the patient's health, anatomical features), the doctor may prescribe a suprapubic puncture and drainage. This manipulation performs two functions - therapeutic and diagnostic.
• If hematuria of urolithiasis is detected, antispasmodics and thermal physiotherapy procedures are indicated to promote the activation of the removal of stones.
• If urolithiasis manifests itself with blood in the urine, painful symptoms and does not respond to conservative treatment, surgery or cystoscopy may be prescribed.
• Traumatic damage to kidney tissue (ruptures, internal hematomas), profuse hematuria, ARF (acute renal failure) are treated surgically on an urgent basis.
• Chronic types of uropathologies, kidney diseases, including those manifested by hematuria, are treated according to the identified nosology. Antibiotics, corticosteroids (for proteinuria), vitamin preparations, uroseptics, physiotherapy, and homeopathy are prescribed.

A more detailed algorithm that involves treating red urine:

1. After the diagnosis is made and differentiated, hemostatic treatment is prescribed according to indications (blood transfusion in particularly severe cases or taking tablet forms of the drug, as well as infusion therapy).
2. If a trauma causing hematuria is diagnosed, strict bed rest and hypothermic procedures are indicated. In difficult situations, urgent surgical intervention is performed (subcapsular hematoma) - resection, nephrectomy, suturing of damaged parenchyma tissues.
3. If inflammation of an infectious nature is determined, it is recommended to carry out antibacterial therapy in combination with hemostatics, constantly monitoring the level of hemoglobin in the blood and the presence of red blood cells in the urine.
4. Tumor processes require surgical treatment – embolization of the damaged vessel(s), resection of the tumor sector of the kidney.
5. Prostatitis accompanied by hematuria is usually treated surgically - transurethral or transvesical adenectomy.

Thus, treatment of red urine as one symptom is inappropriate without collecting anamnesis and drawing up an accurate clinical picture of the process. The therapeutic plan is developed only on the basis of analytical information, and its choice is directly determined by the main etiological factor that caused hematuria.

What to do?

A normal urine indicator is considered to be a light yellow, straw-colored color, any change in the color of urine indicates a malfunction of the entire urinary system. Factors causing such shifts in the color spectrum can be either transient, not considered pathological, or associated with diseases in acute or chronic form.

What to do if red urine appears after eating foods containing plant pigment?

1. If a person associates the red, pink color of urine with diet, one should observe the discharge during the day. Usually on the second day the urine acquires a normal light color, since biochromes (plant pigments) are excreted from the body quite quickly.
2. If on the second or third day the urine continues to be colored in an atypical shade, you should undergo an examination and take a general urine test to identify the true cause of the change in indicators.

Urine may also change color during treatment with specific drugs, which is usually warned about by the doctor or the instructions accompanying the drug. This condition is not pathological, urine returns to normal 2-3 days after the end of taking the drug. There is also a definition of "march hematuria", when urine changes color after prolonged or isolated overloads, physical overexertion. In such a situation, you should give the body a rest, restore water balance (drink plenty of fluids) and monitor urine excretion for 1-2 days.

What to do if red urine is not caused by food products that contain biological pigments?

1. If the urine has changed color, you should not self-medicate. The first step is to visit a doctor and complain about red urine.
2. The following examinations will be prescribed: General urine analysis (OAM, urine analysis according to Nechiporenko), blood tests (OAC, ESR, biochemical analysis), ultrasound of internal organs, urography of the kidneys.
3. After receiving the examination results, the doctor will determine the factors, the cause of the change in urine parameters and prescribe treatment - conservative, with a course of antibacterial drugs, uroseptics and other drugs. If the situation requires immediate intervention (total macrohematuria, the disease in the acute stage), hospitalization and treatment in a hospital setting are possible. Surgical intervention is indicated when there are threatening symptoms and a risk of critical blood loss or acute renal failure.

Recommendations for action in the event that red urine is excreted in combination with other alarming symptoms:

1. Call an emergency ambulance.
2. Take a comfortable position to reduce pain.
3. If possible, collect urine, ideally a three-glass sample, for analysis.
4. Lay out and prepare the medications available at home. The doctor needs to know what was taken before the arrival of emergency medical care in order to quickly determine the primary cause of hematuria.
5. Be prepared to answer the doctor’s questions – when the first signs of reddened urine appeared, whether blood appears in the urine once or constantly, whether there was an injury, bruise, chronic kidney disease, whether there is pain and what kind.

People at risk - pregnant women, women and men over 45 years of age, children with congenital nephropathologies, FSC (frequently ill children) - should undergo screening examinations of the urinary system in the manner prescribed by the attending physician.

Drug treatment

Treatment of hematuria or red urine caused by physiological reasons does not have a single therapeutic protocol. Medicines are selected after diagnostic measures, taking into account the characteristics of the process and the identified etiological factor. Most often, erythrocytes in urine, a change in the color spectrum is caused by kidney diseases, UUS (urinary system). If the patient is diagnosed with microhematuria, therapy is carried out according to the treatment protocols for the underlying disease that provokes the symptom. Macrohematuria, characterized by the release of visible erythrocytes into the urine, is treated with hemostatic drugs, conservatively (antibiotics, detoxification) in 35-40% of cases, and also surgically. Let's consider drugs from the group of coagulants (hemostatics):

1. Dicynone. Etamsylate is an angioprotector and coagulant. Stops and prevents parenchymatous types of bleeding. It has a strict contraindication - porphyria and a tendency to thrombosis. Pregnant women are prescribed the drug only when the benefit of using it outweighs the potential risk of harm to the fetus. It is not prescribed to children under 3 years of age. Release form - tablets and injections. For adults: 1-2 tablets (up to 500 mg once). Before surgery, as a means of preventing bleeding, including hematuria - 1 hour before the procedure, 500 mg. To stop bleeding - 2 tablets of 250 mg immediately, repeat the dose after 8-10 hours, observe the dynamics of the process. To stop bleeding of vascularized tissues, ampoules (2 ml) can be effective - intramuscularly or intravenously. The frequency of administration is determined by the physician based on the clinical picture and the results of the initial tests.

1. Vikasolum, Vikasol (Menadione sodium bisulfite). A drug that activates the production of prothrombin, proconvertin (F VII), a synthetic analogue of vitamin K. Available in the form of an injection solution, tablets and powder. Indicated for hemorrhagic bleeding, hematuria diagnosed as a consequence of a chronic urological disease. Often prescribed 1-3 days before surgery, as well as for parenchymal bleeding. Contraindicated in case of suspected thromboembolism, in the last trimester of pregnancy, ARF (acute renal failure), hepatopathologies in the acute stage. Adults are prescribed up to 30 mg per day (2 times a day, 1 tablet each), infants under 1 year old according to indications 2-4 mg per day, the dosage can be increased with age, it is determined by the attending physician. The course of treatment does not exceed 4 days, then a break of 3-4 days is mandatory. Treatment is carried out under the control of the state of the blood composition and depends on the results of monitoring the general therapeutic complex.

Medicines intended to neutralize inflammation, the root cause of the appearance of red urine, can be from the category of antibiotics, uroseptics, and herbal remedies.

1. Monural (fosfomycin), a broad-spectrum antibacterial drug. Effective against many Gram+ bacteria (Gram-positive bacteria). Prescribed for many inflammatory diseases of the urinary system. Available in the form of granules for dilution. Taken before meals or before bedtime, after meals, once. Granules are dissolved in purified water at room temperature, 1 sachet (3 g) per 1/3 glass of water. For children, the dosage is selected by the doctor according to the clinical picture of the disease, the age of the child and the specifics of the course of the process. There are few contraindications, they mainly concern severe forms of nephropathologies.

2. Furamag (nitrofuran). An effective broad-spectrum antimicrobial drug against Proteus, Staphylococcus, Streptococcus, Enterobacter aerogenes, Salmonella, Shigella. Furamag also helps to activate the immune system and reduces general intoxication of the body. The drug is contraindicated for babies under 1.5-2 months, in case of acute renal failure, polyneuritis, and it should not be prescribed to pregnant and breastfeeding women. The course of treatment is up to 10 days, the dosage for adults is 2-4 times a day, 1 capsule (25 mg), depending on the identified nosology. The drug is prescribed to children according to the scheme: 5 mg per 1 kg of the child's weight is the maximum dose per day.

The list of the most effective drugs that have rightfully earned approval in urological and nephrological practice is large. The choice of drug, the frequency of taking drugs is the prerogative of the doctor, the course of treatment depends on the etiology of the disease and is based on analytical diagnostic data.

Vitamins

In the complex treatment of urological pathologies, kidney diseases, additional methods such as physiotherapy and vitamin therapy play an important role. Vitamins should be prescribed taking into account the specifics of the process, there are no uniform recommendations, and in principle cannot exist in medical practice. However, there are universal effects of the impact that vitamins have on the body as a whole, this effectiveness is used by urologists, nephrologists, hematologists and other narrow specialists involved in the treatment of the underlying causes that caused a change in the normal color of urine, including hematuria.

List of vitamins and their effects:

• Pantothenic acid (B5) is responsible for the activity of the immune defense, participates in the synthesis of ACTH and corticosteroids (the work of the adrenal glands).
• Vitamin B6, Pyridoxinum is involved in the immune defense, stimulates and supports, activating the production of antibodies against viral and bacterial inflammation.
• Hematopoiesis stimulator, Cyanocobalamin, vitamin B12. Participates in increasing the efficiency of phagocytes, helps in the process of tissue regeneration, optimizes carbohydrate metabolism, helps the formation of nucleic acids, activates erythropoiesis (maturation of red blood cells). Prescribed in combination with ascorbic acid and vitamin B5 as an activator of immune protection and as an auxiliary agent for the prevention of anemia of various etiologies.
• Аscorbic acid, vitamin C. Ascorbic acid is effective in regulating oxidative processes, effective as an antioxidant. The vitamin accelerates the synthesis of collagen fibers, tissue regeneration, participates in the detoxification of the body, increases resistance to infections.
• Vitamin A, Retinolum. Retinol acetate is one of the most powerful antioxidants. The vitamin is irreplaceable for maintaining the activity of the immune function, general regulation of metabolic processes. Retinol is involved in the normalization of the state of intercellular membranes, thereby promoting the acceleration of tissue regeneration. In addition, retinol acetate effectively interacts with many drugs and "colleagues" in the vitamin series, such an alliance is especially productive in the fight against infectious inflammations.
• Tocopherol, Tocopherol, vitamin E. Radioprotective, angioprotective, antioxidant action, accelerates cellular metabolism, strengthens the walls of capillaries and blood vessels. The vitamin is good as an immunomodulator, activator of blood microcirculation, prevents the formation of blood clots, participates in the work of the hormonal system.

Vitamin complexes and individual vitamins in various forms (tablets, injections, solutions) are prescribed as part of a general therapeutic complex and cannot be an independent, separate method of treating diseases of the urinary system.

Physiotherapy treatment

Physiotherapy in urology and nephrology is an important part of the therapeutic complex. Physiotherapeutic treatment has a short list of contraindications and is considered a low-traumatic method capable of consolidating the result and preventing relapses of the disease. As a pathogenetic method, physiotherapeutic treatment in the presence of hematuria should be combined with etiotropic methods that eliminate the cause of blood in the urine. The impact of physical manipulations activates and potentiates the overall effect of treatment (medicines) by enhancing the polarization of plasma membranes and accelerating the activity of transport ATP phases.

The choice of physiotherapy options is always made by the attending physician, taking into account the general clinical features of the course of the process and possible side effects.

Options for procedures that may be indicated when the symptom of hematuria is detected and after diagnostic procedures have been performed:

• Magnetic therapy.
• Inductothermy.
• Endourethral laser therapy.
• Ultraviolet irradiation (UV irradiation of blood).
• Heat therapy (applications of ozokerite, paraffin, psammotherapy).
• Laser therapy.
• Diathermy.
• Darsonvalization.
• Prostate massage.
• Peloidotherapy (therapeutic mud).
• Decimeter therapy.
• Dynamic amplipulse therapy.
• Short-pulse electroanalgesia (DiaDENS-T device).
• SMT therapy (sinusoidal modulated currents).
• Endovesical phonophoresis.
• Mineral waters.
• Intrarectal laser therapy.
• Electrophoresis.

Physiotherapy treatment is not carried out if there are such contraindications:

• Renal colic in urolithiasis.
• Persistent disruption of excretory function and urine outflow.
• Acute forms of urological diseases, nephropathologies.
• Anuria.
• Extensive bleeding, total macrohematuria.
• Oncologic processes.

Folk remedies

If hematuria is defined as a short-term, transient condition without alarming accompanying symptoms, folk remedies can be used. It is advisable to do this under the supervision of the attending physician and without experimenting in the field of independent selection of recipes. Below are proven methods recommended by specialists, herbalists:

1. Each ingredient should be crushed and take 1 tablespoon. Mix horsetail, elder flowers, knotweed, St. John's wort (4 components). The mixture is poured with boiling water (1 liter), infused in a closed container for at least half an hour. The strained infusion is taken 200 ml on an empty stomach in the morning and evening, 30 minutes after eating. Course 0 7-10 days until the symptom of "red urine" disappears and the result is consolidated.
2. Arctostaphylos (bearberry). 1 tablespoon of leaves is poured with 0.5 l of boiled water, brought to a boil over low heat (after boiling, immediately remove the container from the heat). A decoction of "bear ears" (as bearberry is popularly called) helps to reduce discomfort during cystitis, activates the outflow of urine. You need to drink a decoction of bearberry as often as possible, fractionally, in small portions, literally 1 sip every half hour. The duration of admission is at least 5 days. Please note that a decoction of bearberry can again change the color of urine - to a greenish tint, this should be considered normal.
3. Achillea millefolium, honey yarrow, was not accidentally named after the ancient hero Achilles. In ancient times, this plant was used for almost all diseases. In urology, yarrow is used as a herbal remedy containing organic acids (salicylic, formic, isovaleric), azulenes, monoterpenoids, alkaloids, camphor. The herb has a hemostatic, bactericidal property. Traditional treatment with yarrow requires caution, as it has contraindications (allergies, thrombosis, pregnancy). Recipe: 4 tablespoons of dry grass are boiled in 1 liter of purified water for 3-5 minutes. Then the decoction is poured into a thermos and infused for 10-12 hours. You need to drink the infusion 1 teaspoon, fractionally, every 2 hours. The course is 5-7 days, monitoring the change in urine color and general health.

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Herbal treatment

Phytotherapy in the presence of symptoms - red urine can be used as a preventive measure or strictly as prescribed by a doctor. Herbal treatment is not as safe as it may seem, especially when it comes to hematuria caused by serious pathology. Haematuria, erythrocyturia can be partially stopped by herbal remedies that perform an auxiliary function in the general therapeutic complex.

1. Barberry is known for its unique properties to stop bleeding, neutralize bacterial infections, and relieve spasms due to berberine, which is part of the plant. Recipe: pour 0.5 liters of boiling water over 2 tablespoons of crushed dry barberry roots and leave for 1 hour. Take warm, half a glass 3 times a day before meals. The course is at least 14 days. Another way is to crush 35-40 g of berries, pour 1 glass of cold water over them, bring to a boil and cool. Then the remedy should be diluted with boiled water so that the volume reaches 1 liter. After straining the broth, you can drink it twice a day, half a glass at a time. The course of treatment with barberry berries is 10-14 days.
2. Ginger, the royal spice, is able to stop inflammation of various etiologies, relieve swelling, improve the process of hematopoiesis, strengthen the walls of blood vessels and capillaries, neutralize spasms and help in the treatment of urolithiasis. Method of application: 1 teaspoon of green tea is mixed with 1 teaspoon of ginger root (previously peeled and grated on a fine grater). The mixture is poured with 0.5 liters of boiling water, infused for 20-25 minutes, cooled to an acceptable temperature and drunk like tea during the day (2-3 times a day). Ginger tea can be drunk in long courses, up to 1 month. Then you should take a short week-long break and treatment with ginger broth can be continued. Contraindications for taking ginger may be pregnancy and breastfeeding. Also, people suffering from diseases of the gastrointestinal tract, prone to exacerbation of the process, should drink this tea with caution.
3. As a hemostatic herbal remedy, you can drink a decoction of nettle, parsley and rose hips. Mix 1 tablespoon of each component, take 2 tablespoons of the herbal mixture and pour a liter of boiling water. Keep the infusion for at least 30 minutes. Strain and drink warm (50-60 degrees) a tablespoon quite often - every 40-60 minutes. The course does not last long, this method is intended to stop bleeding. If red urine continues to be released for more than a day, you should immediately stop herbal treatment and seek medical help.

Homeopathy

Hematuria requires careful selection of means for the course of treatment. Classification of red urine suggests many reasons that provoke the presence of red blood cells in the urine. Therefore, homeopathy is prescribed only after a comprehensive examination, relief of acute symptoms and elimination of alarming, threatening risk factors.

Let's consider several options in which homeopathy can play a positive role as an effective method of self-treatment or consolidation of the therapeutic result after taking a course of traditional drugs.

1. Glomerulonephritis is usually treated with cytostatics, corticosteroids, anticoagulants, diuretics. The course of treatment is very long - from 6 months to 1 year or more, so after the acute condition is relieved, homeopathy will perform a buffer function during the break between treatment with complex (cytostatic, steroid) drugs, temporarily replacing drugs without losing the achieved therapeutic effect. The following drugs are indicated:
   • Arsenicum album. An antiseptic medicine that reduces fever and intoxication. In granules - in acute forms of the disease, it is prescribed in dilutions C3, C6, C9. Chronic course requires taking the drug in dilution C30. The medicine is taken once in the regimen selected by the doctor. Adults - high dilution (15-30), taken once, once a week or month, 8-10 granules. Under the tongue 30 minutes before meals. Arsenicum is strictly contraindicated in case of exacerbation of gastrointestinal diseases (ulcerative forms) and acute renal failure.
   • Mercurius corrosivus, a complex drug based on sulima. The medicine can relieve spasms, reduce body temperature, and swelling. It is prescribed by a specialist based on the individual characteristics of the patient. Mercurius is available in dilutions - C3, C6 and more. High dilutions are indicated for chronic conditions, acute forms of the disease can be stopped with low dilutions (granules or drops).
   • Apis mellifica, a homeopathic pain reliever, dilutions - 3, 6, 9, 12 and 30. For glomerulonephritis, Apis is indicated in a dilution of 6. The medicine is taken an hour or 1 hour after a meal. Dosage: adult patient - 9-10 granules sublingually (under the tongue) every 1.5-2 hours; children from 3 to 14 years old - 3-5 granules under the tongue, taken every 2 hours. The method of administration can be adjusted by a homeopathic doctor.

1. Cystitis, which is often accompanied by red urine:

• Solidago compositum C (Biologische Heilmittel Heel GmbH). Injectable drug, administered as intramuscular injections, 2.2 ml (1 ampoule) 1 to 3 times a week for 21 days.
• Renel (Heel GmbH), a multi-component preparation in tablet form (resorption). Take half an hour before meals, 1 tablet twice or three times a day as prescribed by a homeopath. Acute forms of cystitis - dissolve 1 tablet every 15-20 minutes for 1.5-2 hours. Renel is indicated for children from 3 years of age, the dosage is selected strictly on an individual basis.

Homeopathy is effective only when diagnosed as one of the treatment methods included in the overall therapeutic plan.

Surgical treatment

Hematuria as one of many symptoms of various conditions and pathologies does not require surgical intervention. Surgical treatment is indicated only in emergency situations, severe diseases and acute forms of diseases. Symptomatic therapy may include a wide range of antibacterial drugs, hemostatics, antiviral drugs. If conservative methods do not give the desired result, hematuria is not stopped, surgical treatment is carried out only taking into account the ratio of potential effectiveness and risks.

Indications for surgical treatment:

• Neoplasms in the genitourinary system (benign or prone to malignancy).
• Urological emergencies – septic shock, anuria, urosepsis.
• Macrohematuria with intense internal bleeding, risk of losing a large amount of blood.
• Bladder abscess.
• Large stones in the ureter.
• Kidney injuries.
• Periurethral abscess.
• Nephrolithiasis.
• ARF - acute renal failure.
• Ureteral stricture.

Surgical treatment, methods:

• Embolization of the renal artery.
• Nephrectomy (radical, laparoscopic - as indicated)
• Endoscopic cauterization (coagulatio) of bleeding vessels.
• Endoscopic transurethral resection (TUR) of the bladder.
• Crushing of bladder and ureter stones.
• Percutaneous puncture nephrostomy.
• Cystoscopy (as a method that performs two functions - diagnostic and therapeutic).
• Cystectomy.
• Adenomectomy.
• Resection of a sector or an entire organ of the urinary system according to indications.

Surgical intervention for hematuria is an extreme method when conservative measures are ineffective, or when the patient is at risk of losing a critical amount of blood.

Prevention

It is incorrect from a medical point of view to talk about special preventive measures to prevent hematuria. Red urine is not a disease, but a clinical sign. Prevention should concern the underlying disease that causes the change in urine color.

General recommendations on which prevention of urinary system diseases can be based:

• Compliance with daily hygiene procedures (personal hygiene).
• General hardening of the body, which significantly reduces the risk of viral infections.
• Eat foods of natural origin that do not contain chemical or toxic components; limit oxalates (rhubarb, peanuts, spinach).
• Maintaining a drinking regimen and water-salt balance (1.5-2.5 liters of liquid per day).
• Avoiding situations that provoke stagnation of urine in the vesica urinaria (bladder).
• Follow the rules of safe intimate contact (contraception, prevention of STDs – sexually transmitted diseases, including HIV).
• Maintain physical fitness, move more.
• Give up habits that worsen your overall health and carry the risk of developing serious pathologies (smoking, drinking alcohol).
• Prevent the spread of infection in a timely manner, sanitize infection sites – potential sources of development of the pathological process.
• Undergo routine medical check-ups and examinations - urologist, gynecologist, dentist.
• Seek professional medical help promptly in cases of clinical signs indicating a pathological process in the genitourinary system.

Forecast

Red urine is not an independent noology, it is a symptom. The prognosis is determined by the underlying disease and depends on how serious the identified cause of hematuria is. Favorable outcomes occur in almost 100% of cases of urine color change due to physical overload, active training or consumption of foods containing anthocyanins, betocyanins (biochromes, natural pigments).

A prognosis that cannot be considered positive depends on the specifics of the etiological factor, the type and form of pathology, as well as on accurate diagnostics and the effectiveness of therapeutic efforts. In what situations can we not speak of a favorable outcome of the entire process as a whole:

1. Total hematuria caused by the following diseases:

• Nephritis.
• Fibrous stenosing periurethritis.
• Cystic pyeloureteritis.
• Ureteral prolapse.
• Polycystic kidney disease.
• Renal artery aneurysm.
• Nephroptosis.
• Tuberculosis of the kidneys.

2. Tumors and oncologic processes of the urinary system (URS):

• Acute non-lymphoblastic leukemia, AML (acute myeloid leukemia).
• Transitional cell carcinoma.
• RCC (renal cell carcinoma).

3. Congenital anomalies in the development of the urinary system.

In general, early visits to a doctor, timely diagnostics and adherence to basic rules of care for one's own health make it possible to say that the prognosis for the treatment of the underlying disease will be positive. Patients most often undergo outpatient treatment, being observed by a specialist for a year, less often - for a long time. Prevention and regular dispensary examinations prevent the development of pathological processes and allow to significantly increase the statistics of favorable prognoses concerning diseases of the genitourinary system.

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