About- Blood in the urine, medically known as hematuria, occurs when red blood cells are present in the urine. The blood may be visible, making the urine appear pink, red, or cola-colored, or it may be present in such a small amount that it can only be detected through a urine test. Blood in the urine can come from any part of the urinary system, including the kidneys, ureters, bladder, prostate, or urethra. In some cases, hematuria may occur temporarily and may not indicate a serious problem. However, it can also be a sign of a urinary tract infection, kidney or bladder stones, prostate problems, or, less commonly, cancer. Blood in the urine should not be ignored, particularly when it is visible or occurs repeatedly. A healthcare professional can determine the underlying cause through a medical history, examination, urine tests, and other investigations when necessary.
1. Gross Hematuria- Gross hematuria occurs when there is enough blood in the urine to be visible to the naked eye. The urine may appear pink, bright red, dark red, or cola-colored.
2. Microscopic Hematuria- Microscopic hematuria occurs when blood is present in the urine but cannot be seen with the naked eye. It is usually discovered during a urine test performed for another reason or as part of a routine examination.
Blood in the urine can have many possible causes. Some are temporary or relatively minor, while others require medical evaluation.
Urinary Tract Infection (UTI)- A urinary tract infection can cause inflammation and irritation of the urinary tract, sometimes resulting in blood in the urine. UTIs may also cause burning while urinating, frequent urination, urgency, lower abdominal discomfort, and cloudy or strong-smelling urine.
Kidney or Bladder Stones- Kidney stones and bladder stones can scrape or irritate the lining of the urinary tract, causing bleeding. Stones may also cause severe pain in the back, side, lower abdomen, or groin.
Kidney Infection- A kidney infection can cause hematuria along with fever, chills, back or side pain, nausea, and urinary symptoms.
Bladder Infection- A bladder infection can cause blood in the urine along with frequent urination, urinary urgency, burning, and discomfort in the lower abdomen.
Enlarged Prostate- In men, an enlarged prostate, also called benign prostatic hyperplasia (BPH), can sometimes cause blood in the urine. It may also cause difficulty starting urination, a weak urine stream, frequent urination, and difficulty completely emptying the bladder.
Prostate Infection- Prostatitis, or inflammation or infection of the prostate, may cause blood in the urine. Other symptoms can include painful urination, pelvic discomfort, fever, and difficulty urinating.
Cancer- Blood in the urine can sometimes be an early warning sign of cancer involving the urinary system. Possible cancers include:
Bladder cancer
Kidney cancer
Prostate cancer
Visible blood in the urine should therefore be medically evaluated, even when there is no pain.
Glomerulonephritis- Glomerulonephritis is inflammation of the tiny filtering units of the kidneys. It can cause blood and protein to appear in the urine and may occur following certain infections or as part of an immune-related condition.
Blood Clotting Disorders- Conditions that interfere with normal blood clotting can increase the risk of bleeding, including bleeding into the urinary tract. Examples include hemophilia and other bleeding disorders.
Sickle Cell Disease- People with sickle cell disease may develop blood in the urine because of changes affecting the kidneys and urinary system.
Polycystic Kidney Disease- Polycystic kidney disease causes multiple fluid-filled cysts to develop in the kidneys. Bleeding from a cyst or other kidney-related complications can sometimes result in hematuria.
Endometriosis- In rare cases, endometriosis involving the urinary tract can cause blood in the urine, particularly around the time of menstruation.
Certain Medicines- Some medicines may increase the risk of blood appearing in the urine or make bleeding more likely. These can include certain blood thinners, pain relievers, and other medicines. Medication-related hematuria should be assessed by a healthcare professional rather than assuming that the medicine is the only cause.
Injury or Trauma- An injury to the kidneys, bladder, or other parts of the urinary tract can cause blood in the urine. This can occur after accidents, falls, sports injuries, or other significant trauma.
Vigorous Exercise- Intense or prolonged physical activity can occasionally cause temporary hematuria. However, blood in the urine after exercise should not automatically be attributed to exercise, especially if it is persistent or recurrent.
Sexual Activity- Sexual activity can occasionally cause minor irritation or injury that results in temporary blood in the urine. However, persistent or unexplained hematuria requires medical evaluation.
Menstruation- Menstrual blood can mix with a urine sample and make it appear that blood is present in the urine. If hematuria is suspected during menstruation, a healthcare professional may recommend repeating the urine test after menstruation has ended.
Other Infections and Conditions- Certain infections, including some streptococcal infections and hepatitis-related conditions, can be associated with kidney inflammation and blood in the urine.
You should contact a healthcare professional if you notice blood in your urine, particularly if it is visible or occurs more than once. Seek prompt medical attention if blood in the urine is accompanied by:
Severe pain in the back, side, abdomen, or groin
Fever or chills
Inability to urinate
Large blood clots in the urine
Heavy or persistent bleeding
Dizziness, weakness, or fainting
Blood in the urine following a significant injury
Even painless visible blood in the urine should be evaluated because some important urinary tract conditions can cause bleeding without pain.
A healthcare professional will first ask about your symptoms, medical history, medicines, recent infections, injuries, exercise, and other relevant factors. Tests may include:
Urinalysis- A urinalysis can detect blood, red blood cells, protein, signs of infection, and other abnormalities in the urine.
Urine Culture- If a urinary tract infection is suspected, a urine culture may be performed to identify bacteria and help determine appropriate treatment.
Blood Tests- Blood tests may be used to evaluate kidney function, blood counts, or other conditions that could contribute to hematuria.
Imaging Tests- Depending on the suspected cause, imaging tests such as an ultrasound, CT scan, or MRI may be recommended to examine the kidneys, bladder, or urinary tract.
Cystoscopy- A cystoscopy allows a urologist to examine the inside of the bladder and urethra using a thin instrument with a camera. It may be recommended when the cause of hematuria needs further investigation.
Treatment depends on the underlying cause of the hematuria.
Urinary tract infections: Antibiotics may be prescribed when a bacterial infection is confirmed or strongly suspected.
Kidney or bladder stones: Treatment may include increased fluid intake when appropriate, pain management, medication, or procedures to remove or break up larger stones.
Enlarged prostate: Treatment may include medicines, minimally invasive procedures, or surgery depending on the severity of symptoms and other factors.
Kidney disease: Treatment is directed at the specific kidney condition and may include medicines and monitoring of kidney function.
Injury: Treatment depends on the location and severity of the injury.
Cancer: Treatment depends on the type and stage of cancer and may include surgery, medicines, radiation therapy, or other cancer treatments.
Medicine-related bleeding: A doctor may review the medicines being taken and decide whether any changes are appropriate.
Do not stop taking prescribed blood thinners or other medicines on your own because of blood in the urine. Discuss the problem with your healthcare professional.
Hematuria itself is a symptom rather than a disease, so possible complications depend on its underlying cause. For example, untreated infections can spread to the kidneys, while urinary stones can cause obstruction and significant pain. Conditions affecting the kidneys may lead to impaired kidney function if left untreated. When hematuria is associated with cancer, delaying evaluation may delay diagnosis and treatment.
No. Hematuria can result from infections, stones, strenuous exercise, medicines, menstruation, or other causes. However, visible or unexplained blood in the urine should be evaluated because it can sometimes be associated with more serious conditions.
Yes. Hematuria can occur without pain. In particular, some urinary tract conditions, including certain cancers, may cause painless visible blood in the urine.
Urine containing blood may appear pink, red, dark red, brown, or cola-colored. The appearance can vary depending on the amount of blood and other factors.
Yes. A urinary tract infection can cause blood in the urine, often together with burning during urination, frequent urination, urgency, and lower abdominal discomfort.
Yes. Even a single episode of visible blood in the urine should be discussed with a healthcare professional, particularly when there is no obvious explanation.
Intense exercise can sometimes cause temporary hematuria. However, blood in the urine should not automatically be assumed to be caused by exercise. Persistent or recurrent bleeding should be evaluated.
Some medicines can increase the risk of bleeding or may be associated with hematuria. Tell your healthcare professional about all medicines and supplements you take.
A urologist commonly evaluates hematuria. Depending on the suspected cause, other specialists such as a nephrologist or hematologist may also be involved.
Medical Disclaimer: This information is intended for general educational purposes and is not a substitute for professional medical advice, diagnosis, or treatment. If you have blood in your urine, consult a qualified healthcare professional for an appropriate evaluation.
