Understanding Occult Blood and RBC in Urine: What Does It Mean?

Both occult blood (1) and RBC 3-5/HPF are findings in a urinalysis. These terms might seem alarming, but let's break down what they mean and whether they are something you should be concerned about.

What Do Occult Blood (1) and RBC 3-5/HPF Mean?

Occult means that the blood is hidden from the naked eye but is detectable through testing. In the context of urinalysis, this means that the blood is not visibly present in the urine but can be found using specific testing methods, such as a urinalysis with microscopic examination.

A urine dipstick test that shows a result of 1 or above indicates the presence of significant hematuria, which is blood in the urine. A trace amount is considered a negative result or no visible blood to the naked eye. RBCs or red blood cells are detected when the urine sample is examined under a microscope. A general concern arises if more than 3-5 RBCs per high power field (HPF) are found.

Are These Results Normal?

No, these results are not normal. However, it's important to note that the presence of hematuria does not always indicate a serious health issue. Mild to moderate hematuria can occur due to various harmless reasons, such as strenuous exercise, minor trauma, or even an activity like sexual activity (masturbation).

For people over the age of 40, a higher number of RBCs in the urine warrants more attention, as it can be a sign of a serious condition. Microscopic examinations, such as a urine sediment test, can reveal other cellular elements like white blood cells (WBCs), epithelial cells, or rarely, tumor cells. An elevated number of WBCs (more than 2-5 WBCs/hpf) can indicate an infection or inflammation in the urinary tract.

What Are the Causes of Hematuria?

Hematuria can have different causes, ranging from harmless to severe. Some common causes include:

Exercising: Strenuous physical activities can cause small amounts of blood in the urine. Infections: Urinary tract infections (UTIs) can cause visible blood in the urine. Kidney Stones: The sharp pain and friction caused by kidney stones can lead to hematuria. Medications: Certain medications can cause the kidneys to produce blood in the urine. Cancer: While rare, blood in the urine could be a sign of kidney, bladder, or prostate cancer.

In general, if you notice some blood in your urine, especially if it persists, you should consult a clinician. They can provide a proper diagnosis and necessary treatment.

What Should You Do?

If a test strip shows occult blood 1 and a microscopic follow-up identifies 3-5 RBCs per HPF, you should be cautious. For women, this result might be normal if it coincides with the beginning or end of their menstrual cycle. However, for others, a repeat urinalysis is recommended to see if the RBC count stays elevated. Persistent hematuria beyond a single occurrence should be evaluated by a healthcare provider.

Conclusion

It's important to take these test results seriously but also to not jump to conclusions. Understanding the potential causes of hematuria can help you make informed decisions about your health. Always consult with your healthcare provider for a thorough evaluation and appropriate medical advice.

For more detailed information, you can refer to medical literature or consult with a healthcare professional.