Heal with Confidence: Why Patients Fly to India for Hematuria Treatment

Hematuria treatment

Blood in urine is not a disease in itself but a symptom of other problem. The cure is based on the cause, the severity and the overall health of the patient.

Here’s an overview:

Common Causes of Hematuria

• Urinary tract infection (UTI)
• Infection of the kidney (pyelonephritis)
• Kidney or bladder stones
• Enlarged prostate (in men)
• Gangular 0uphritis (inflammation of kidney filters)
• Kidney disease or injury
• Bladder or kidney cancer
• Strenuous exercise
• Some of the drugs (blood thinners, analgesics)

Treatment (Causal)

Urinary Tract Infection

• Antibiotics (on the prescription of the urine culture).
• Increase water intake.

Kidney or Bladder Stones

• Pain relievers.
• Drugs that are used to clear tiny stones.
• That would be shockwave lithotripsy, ureteroscopy or surgical treatment of larger stones.

Enlarged Prostate (BPH)

• Alpha-blockers or 5-alpha-reductase.
• Least amount of surgery or surgery when severe.

Glomerulonephritis / Renal Disease

• Blood pressure (ACE inhibitors, ARBs).
• Corticosteroids or immunosuppressants (in case related to immune).
• Dialysis (in severe cases).

Bladder or Kidney Cancer

• Depending on the stage, surgery, chemotherapy, radiation or immunotherapy.

Exercise-Induced Hematuria

• Usually self-limiting.
• The patient should not exercise usually until the clearance.

Supportive Care

• Adequately hydrate by drinking a lot of fluids to clear the urinary tract.
• Keep off irritants such as caffeine, alcohol and smoking.
• Watch the color and frequency of urine.

Hematuria diagnosis and treatment

Diagnosis of Hematuria

• As hematuria may occur at any point in the urinary tract (kidneys, ureters, bladder, prostate, urethra), physicians tend to proceed in the following order:

Medical History/Physical Exam

• Inquiries to make: pain, frequency, fever, recent exercise, trauma.
• Test kidney stones history, infections, smoking, medications (blood thinners).

Urine Tests

• Urinalysis: red blood cells, protein, infection, crystals checks.
• Urine culture: identifies bacteria as causes of UTI.
• Urine cytology: examines the presence of cancer in urine.

Blood Tests

• Kidney (creatinine, BUN) function.
• Clotting profile when there is a possibility of bleeding disorder.

Imaging Tests

• Ultrasound: prostate, kidneys, bladder.
• CT Urogram: detailed scan to find stones, tumors or structural problems.
• MRI (occasionally of soft tissue).

Cystoscopy

• Thin scope inserted into bladder to examine presence of tumors, stones or structural anomalies.

Hematuria (Cause-Based) Treatment

• UTI: Antibiotics (e.g. nitrofurantoin, fosfomycin, ciprofloxacin -based on culture), hydration.
• Kidney / Bladder Stones: painkillers, fluids, ureter relaxation, lithotripsy (shock wave), ureteroscopy, or surgery to remove large stones.
• BPH (Big Prostate): Alpha-blocker (tamsulosin), 5-alpha-reductase inhibitor (finasteride), TURP (surgery) in severe cases.
• Glomerulonephritis / Kidney Disease: ACE inhibitors / ARBs to regulate blood pressure, steroids (immunosuppressants), dialysis (severe) when crippling.
• Bladder or Kidney Cancer Surgery: (TURBT, nephectomy), chemotherapy, radiation, immunotherapy depending on stage.
• Exercise-Induced Hematuria: This is usually self-limiting and heals with rest, ongoing hydration, and no overextention.
• UT Trauma: Consideration (in mild case), purulent drainage, surgery in case of severe injury.
• Medication-Induced (blood thinners, NSAIDs): Change/Discontinue a drug when advised by a doctor.

Best hematuria treatment in India

Diagnosis & Treatment Protocols in India

India adheres to evidence-based, internationally-normed practice of hematuria, specific to the cause:

• Chief Complaint (usually by general practitioners or local physicians):
• Do urinalysis, urine culture, and ultrasound.
• Simple UTIs are able to be managed on the first line.
• The cases that may indicate glomerular disease (e.g., fevers, swelling of the face, dysmorphic RBCs, high blood pressure) are to be referred to a nephrologist.
• Results suggesting the presence of malignancy or stones should be urology-referred to advanced treatment.

Specialty Medical Dialogues

Cause-Based Management:

• UTIs → Antibiotic and hydration therapy.
• Stones → It can be hydrated, medicated, lithotripsy, or removed in surgery.
• BPH → Medical treatment, or operation (i.e. TURP or open-surgery) in case of complications such as recurrent UTIs or gross hematuria occur.
• Kidney disease (e.g. glomerulonephritis) → Treated by nephrologists, may need immunosuppressants or dialysis.
• Cancer (bladder/kidney) - Referral to oncology or urology to stage and treat it, including surgery, chemo or radiation.

Follow-up:

• In case of the inconclusive results of the initial work up, further microscopy and blood pressure checks every 3-6 months are suggested, particularly where there are risk factors, such as smoking or exposure to chemicals.

Hematuria causes and treatment

Hematuria may be microscopic (blood may only be seen under a microscope) or gross (blood may be visible in urine).

Common Causes of Hematuria:

Infections

• UTI (Urinary Tract Infection) - bacteria can cause bleeding and inflammation.
• Kidney infection (pyelonephritis) - typically with fever, chills, and flank pain.

Stones

• Bladder or kidney stones - sharp edges scratch the lining and are bleeding.

Prostate Disorders (in men)

• Benign Prostate Hyperplasia (BPH) - swollen prostate can be bleeding.
• Prostatitis -inflammation/infection.

Kidney Conditions

• Glomerulonephritis -inflation of kidney filters.
• Polycystic kidney disease.
• Trauma of kidneys (trauma, accidents).

Cancers

• Bladder cancer, renal cancer or prostate cancer.
• Frequently with painless visible blood in the urine.

Medications

• Anticoagulant (aspirin, warfarin, heparin).
• NSAIDs and some antibiotics.

Other Causes

• Exercise (strenuous exercise, aka runner, hematuria).
• Menstruation (the false hematuria in women).
• Bleeding disorders.

Hematuria Treatment (Depends on Cause):

• UTI: antibiotics (depending on a urine culture), more hydration.
• Kidney/Bladder Stones: Analgesics, rehydration, medicine to expel stones, lithotripsy or surgery in large stones.
• BPH (Enlarged Prostate): Alpha-blockers (tamsulosin), 5-alpha-reductase-inhibitors, surgery (TURP) when severe.
• Kidney Diseases: (Glomerulonephritis, PKD) Blood pressure modulation (ACE inhibitors/ARBs), immunosuppressants (steroids) dialysis when severe.
• Cancers : Surgery, chemotherapy, radiation or immunotherapy by type and stage.
• Medication induced: Dose change or the change of medicines under medical advice.
• Exercise induced: Rest, hydration, self-limiting to treatment in most cases.
• Trauma: Noticing whether mild or surgery-threatening.

Advanced hematuria treatment options

Complex treatment of hematuria - these are usually utilized when first-line therapy (such as antibiotics against UTI or plain medications against stones/prostate) is not sufficient, or when the etiology is more complicated (such as cancers, resistant stones or advanced kidney disease).

State of the art Hematuria treatment:

For Kidney or Bladder Stones

• Shock Wave Lithotripsy (SWL) – is not invasive, destroys stones into tiny pieces through sound waves.
• Ureteroscopy and Laser Lithotripsy- a small scope is inserted into the ureter/kidney and a laser is utilized to fracture stones.
• Percutaneous Nephrolithotomy (PCNL) - keyhole surgery of large/complex stones minimally invasive.
• Mini-PCNL & Micro-PCNL- newer versions, with less bleeding, quicker recovery.

For Enlarged Prostate (BPH)

• Transurethral Resection of Prostate (TURP) - gold standard operation in the removal of overgrowth of prostate tissue.
• Laser Enucleation (HoLEP, ThuLEP) - less invasive laser treatment that is less likely to result in bleeding.
• Urolift & Rezum Therapy- more recent procedures of small scale to open urinary passage without a big operation.

For Bladder or Kidney Cancer

• Transurethral Resection of Bladder Tumor (TURBT) - Tumors of the bladder which are removed endoscopically.
• Intravesical Therapy - The induction of BCG immunotherapy or chemotherapy into bladder.
• Robotic/Laparoscopic Surgery -nephectomy (kidney removal) or cystectomy (bladder removal) using smaller incisions, quicker recovery.
• Targeted Therapy & Immunotherapy - checkpoint inhibitors are advanced drugs used in the treatment of advanced cancers.

Kidney Disease (Glomerulonephritis, Polycystic Kidney Disease)

• Immunosuppressive Therapies- advanced autoimmune based kidney inflammation biologics or targeted drugs.
• Plasmapheresis-purges bad antibodies in blood in some kidney diseases caused by the immune system.
• Dialysis & kidney transplant- in end stage kidney disease with recurrent hematuria.

For Vascular Causes

• Endovascular Embolization- an extremely less invasive operation where interventional radiologists block unnatural blood vessels that trigger blood loss in the kidney or bladder.
• Angioplasty & Stenting- in case hematuria is attributed to the narrowing or malformation of the renal artery.

Unexplained / Refractory Hematuria

• Cystoscopy with Fulguration - laser/ burning of bleeding bladder vessels.
• Intravesical Alum or Formalin Therapy - persistent bleeding of the bladder (last-resort hospital-based therapies).
• Hyperbaric Oxygen Therapy (HBOT) - in cases of radiation induced hematuria (following cancer therapies).

Advanced, Supportive Diagnostics

• Flexible cystoscopy- real time image to locate the source of bleeding.
• CT Urogram & MRI Urogram - detailed images to identify any tumors, stones or vascular malformation which are not evident.

Hematuria specialist doctors in India

• Dr. Rajiv Yadav
• Dr. Gagan Gautam
• Dr. Anil Mandhani
• Dr. Rajesh Ahlawat
• Dr. Anupam Bhargava

Hematuria surgery in India

For Kidney or Bladder Stones

Ureteroscopy Lithotripsy (Laser)

• Endoscopic surgery: a scope that is inserted into the ureter/kidney; laser cuts stones.

Percutaneous Nephrolithotomy (PCNL)

• The use of keyhole surgery on large/complex kidney stones.

Mini / Micro PCNL

• Less invasive and use of small instruments, faster healing.

Shock Wave Lithotripsy (SWL) (non-surgical yet is characterized as a procedure)

• It is the sound waves of the outside that cut stones.

Enlarged Prostate (BPH) in Men

Transurethral Resection of the Prostate (TURP)

• The gold standard surgery, which is done through the urethra, removes prostate tissue.

Laser Enucleation (HoLEP / ThuLEP)

• Less-blood procedures with advanced laser.

Open / Robotic Simple Prostatectomy

• In very large prostates in which TURP is inadequate.

Bladder Tumors / Bladder Cancer

Transurethral Resection of Bladder Tumor (TURBT)

• Bladder tumor causes bleeding which has been removed endoscopically.

Radical orpartial Cystectomy

• Part or total removal of the bladder by surgery (robotic/laparoscopic possible).

Intravesical Therapy (post-surgery)

• Chemo/BCG into bladder as prophylaxis.

Kidney Tumors / Kidney Cancer

Partial Nephrectomy

• Cures tumor, spares kidneys.

Radical Nephrectomy

• Removes the whole kidney (open, laparoscopic or robotic).

Severe or Persistent Bladder Bleeding

Cystoscopic Fulguration

• Laser/ endoscopic treatment of bleeding bladder vessels.

Intravesical Therapies (Alum, Formalin, Fibrin Sealants)

• Placed into bladder to counter uncontrolled bleeding (last-resort).

For Vascular Causes

Endovascular Embolization (MIPS) (minimally invasive radiology procedure).

• Blocks kidney or bladder abnormal blood vessels which lead to bleeding.

Stenting / Renal Artery Surgery

• In case bleeding is as a result of artery abnormality.

Hematuria treatment in India with GetWellGo

GetWellGo is regarded as a leading supplier of healthcare services. We help our foreign clients choose the best treatment locations that suit their needs both financially and medically.

We offer:

• Complete transparency
• Fair costs.
• 24 hour availability.
• Medical E-visas
• Online consultation from recognized Indian experts.
• Assistance in selecting India's top hospitals for Hematuria treatment.
• Expert urologists with a strong track record of success
• Assistance during and after the course of treatment.
• Language Support
• Travel and Accommodation Services
• Case manager assigned to every patient to provide seamless support in and out of the hospital like appointment booking
• Local SIM Cards
• Currency Exchange
• Arranging Patient’s local food