Hematuria (Blood in the Urine)

If bleeding occurs from your kidneys, ureters, bladder, prostate, or urethra, it passes into the urine. The cause may not be serious, but an evaluation is needed to rule out more serious conditions.

Hematuria, or blood in your urine, may only be seen under the microscope. Or you may notice it because your urine has a reddish color. Regardless of the amount, this may be a sign of bleeding from the kidneys, ureters, bladder, prostate, or urethra and should be evaluated.

Oftentimes blood in the urine is painless, but you may experience the following symptoms:

• Urine color changes to pink, red, maroon, or sometimes dark brown
• Burning with urination
• Lower abdominal discomfort, back pain, or pain in the genital region
• Urinary frequency or urgency

There are many possible causes for blood in the urine. It is most commonly due to one of the following:

• Urinary tract infection
• Inflammation
• Kidney stones
• Enlarged prostate
• Kidney cancer
• Bladder cancer
• Previous radiation therapy to the abdomen or pelvis

During your visit your doctor will ask you questions regarding your medical history and will perform an exam with focused attention on the abdomen, genitalia, and potentially a rectal exam (for male patients). Information regarding stone history, infection history, cancer history, and smoking history will also be discussed.

Tests that may be performed during or after your visit:

• Urinalysis: This test looks for any blood or infection in the urine.
• Post-void residual: The physician will often ask you to urinate and then check to make sure you are emptying your bladder.
• Cystoscopy: This is a procedure performed in the office or at a surgery center where the physician inserts a small scope into the urethra to evaluate the urethra, prostate (for males) and bladder.
• Imaging: This will be either a CT scan, MRI scan, or ultrasound depending on your history and kidney function. These tests allow us to evaluate the urinary tract.
• Labs: Urine culture and cytology may be obtained. A urine cytology evaluates the urine cells for evidence of cancer on a microscopic level. Blood work to assess kidney function may also be obtained.

If you notice blood in your urine, drink more fluids (preferably water) to dilute your urine. Most of the time the bleeding will stop on its own. Your treatment will depend on the results of an exam or tests done by your doctor. If bleeding doesn’t stop, steps may need to be taken to remove the source of bleeding. Even if the bleeding stops, it is highly recommended to be evaluated by a urologist if you have ever experience blood in the urine.

Call us (or go to the emergency room if it is after office hours or you cannot be seen in the office) if you notice blood clots, the bleeding doesn’t improve with hydration, or you have difficulty urinating.