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Urinary and Genital Disorders (Children)

Why Does My 11 Yr Old Son Have Blood in Urine

02/18/2009

Question:

Since last september my son has had on and off blood in his urine. It got worse just before Christmas. He was treated for an infection but the blood still keeps happening. The tests didnt show a sign of infection just there was blood there. Since then all his skin on his body has gone sore dry and itchy. Also he says he sometimes feels sick and funny. We are down to see a specialist but it is worrying us and we wondered if you could shed any light on it?

Answer:

It depends on whether the blood in the urine is visible. If it is visible, then it depends on whether it is throughout the stream or just at the beginning or end of the stream. Blood alone is not a sign of infection. If there is a urinary tract infection, there will be white blood cells and bacteria, and the urine culture will be positive.

If there is blood at the beginning or end of the stream, the cause is not serious. It is an indication of bleeding coming from the urethra. Many boys with this have "voiding dysfunction" and often have constipation, and treatment with a laxative such as Miralax often is beneficial. There are also medications to help relax the pelvic floor muscles.

If there is blood throughout the stream, it is probably coming from the kidney or bladder and a sonogram of the urinary tract is important to check for a kidney stone, cyst, or deformity of the urinary tract. If the blood is not visible, it usually is not serious. However, we generally obtain a sonogram of the urinary tract. I do not think his dry skin is related to the blood in the urine.

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Response by:

Jack S Elder, MD, FACS, FAAP Jack S Elder, MD, FACS, FAAP
Clinical Professor of Urology
School of Medicine
Case Western Reserve University