血尿はがんやぼうこう炎などさまざまな疾病が原因となる。目でわかるほどのときは直ちに受診が必要だが、顕微鏡などの検査でしか見えない程度の血尿でも病気が潜んでいることがあるので用心した方がよい。
血尿は腎臓から尿管、ぼうこう、尿道に至るどこかに異常がある場合に出る。痛みや炎症、発熱などを伴うこともあるが、自覚症状のない場合もある。ぼうこう炎や前立腺炎のほか、びうこうがんや腎臓がん、尿路結石、前立腺肥大症など重い疾患の場合もある。
尿潜血反応などの検査でなければわからない程度の血尿もある。女性の五十歳以上では二割以上が検査で陽性になる。該当者はさらに詳しい検査に進むが、それで異常がなくてもがんの危険性が残るため三年間は経過をみる必要がある。
目に見えない血尿があった五十歳以上の男性の約五％にぼうこうがんが見つかったという報告もある。喫煙歴や尿路感染症の既往歴のある場合などは注意が必要
だ。帝京大学の堀江重郎・主任教授は「血尿がストレスで起こると誤解している人もいるが、心理的なものだけで出ることはほとんどない」と指摘する。
血尿への対応表
- 肉眼でわかるときは直ちに泌尿器科を受診
- 顕微鏡検査などでわかった場合は追加検査を
- 追加検査で異常がなくても3年間は経過観察を
- 喫煙者、尿路感染症、排尿障害の経験者は注意
引用元：2008年12月21日 日経新聞SUNDAY NIKKEI「１分間人間ドック」より
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