Blood In Urine

What is blood in urine (hematuria)?

Hematuria (hee-muh-TOOR-ee-uh) is the medical name for the presence of blood cells in your urine (pee).

It’s pretty common for blood to be in your pee. But you may not even know it because it doesn’t always turn your pee pink or red. Sometimes, there’s only a small amount of blood in your pee that you can’t see — healthcare providers discover it during a urine test. But if you notice your pee looks pink or red or you have other hematuria symptoms, it might be a sign that something is wrong. You should reach out to a healthcare provider.

What are the types of hematuria?

Healthcare providers label blood in pee as:

Gross hematuria. This is when there’s enough blood in your pee that it’s visible to the naked eye. It can turn toilet water a pale pink or bright red color.
Microscopic hematuria. If you have microscopic hematuria, you have blood in your pee, but the amount is too small for you to see with your naked eye. You need a microscope to see it.
Dipstick hematuria. Dipstick hematuria occurs when oxidation (exposure to oxygen) of a dipstick causes a color change. Dipsticks are thin strips of plastic or paper with patches of chemicals. The chemicals change colors if you have certain substances in your pee.

Symptoms of Hematuria

Many times, there are no symptoms except blood in your pee. When this happens, a healthcare provider may say you’re “asymptomatic.”

If you have other symptoms, they may include:

Peeing more than usual (frequent urination)
Pain or burning when you pee (dysuria)
A strong need to pee right away (urinary urgncy)

You may have other associated symptoms, too, including:

Nausea and vomiting
Fever
Chills
Lower back pain
Abdominal pain
Pain on either side of your lower back, just above your hips (flank pain)

Having blood in your pee doesn’t always mean you have a condition. But it can be an important warning sign that something is wrong with your body. Don’t ignore it. Contact a healthcare provider as soon as you find blood in your pee.

Causes of Hematuria

There are many different causes of hematuria. Some conditions are more serious than others. Serious conditions may include:

Urinary stone disease. This term describes masses of minerals or other substances that form in your urinary system. This includes kidney stones, bladder stones and ureteral stones.
Urinary tract infection (UTI). This is a bacterial infection in any part of your urinary system.
Kidney infection (pyelonephritis). This is an infection that spreads to your kidney(s).
Bladder inflammation (cystitis). This is when inflammation affects your urinary bladder. It may have infectious or noninfectious causes.

Certain cancers can also cause blood to appear in your pee.

Other conditions that may lead to blood in your pee include:

Enlarged prostate (benign prostatic hypertrophy or BPH). BPH causes your prostate to grow. Your prostate is a gland that produces semen.
Injury to your urinary system. Examples include blunt trauma (like a fall, automobile collision or sports injury) or a penetrating injury (like a knife wound or gunshot wound).
Menstruation. You may see blood in your pee when you have your period.
Endometriosis. This causes tissue that’s similar to your uterine lining (where blood and tissue come from during menstruation) to grow outside of your uterus.
Chronic kidney disease (CKD). CKD affects how well your kidneys work. It’s a long-term (chronic) condition.
Sickle cell disease. This is a condition you inherit from your biological parents that affects your red blood cells.

What cancers cause hematuria?

Different types of cancer can cause blood to appear in your pee. These include:

Bladder cancer
Kidney cancer
Ureteral cancer
Urethral cancer
Prostate cancer

Is hematuria contagious?

No, hematuria isn’t contagious. But a common cause of hematuria is UTIs. Healthcare providers don’t consider UTIs contagious. But sometimes, you can spread the bacteria that cause UTIs to a partner during sexual intercourse.

Who does hematuria affect?

Anyone of any age can have blood in their pee. But you may be more likely to have hematuria if you:

Have a UTI
Have a congenital urinary abnormality
Are 50 or older
Have a biological family history of conditions that affect your urinary system, such as CKD or kidney stones
Take certain medications, including anticoagulants (blood thinners), nonsteroidal anti-inflammatory drugs (NSAIDs) and antibiotics
Smoke
Don’t drink enough fluids (dehydration)
Encounter certain chemicals and/or radiation at work
Work around metals, fumes, dyes or rubbers
Play contact sports, including hockey, soccer, boxing and football
Run long distances or exercise a lot (exercise-induced hematuria)
Have vigorous sexual intercourse

What complications are related to blood in urine?

You may experience side effects of hematuria treatments, including medications and procedures. They vary by treatment, and a healthcare provider will review any possible side effects with you.

But untreated hematuria can lead to bigger problems, especially if the cause is serious. A provider should treat any condition that causes blood in your pee. Early detection of a serious condition leads to early treatment. Your chances of successful treatment increase the sooner you get treatment.

How is hematuria diagnosed?

A healthcare provider will review your medical history, ask you questions about any other symptoms and perform a physical examination, which may include a pelvic exam or digital rectal exam. They may also recommend additional tests to help confirm a hematuria diagnosis.

What tests will be done to diagnose hematuria?

A healthcare provider may recommend the following tests to help diagnose hematuria:

Urinalysis. You pee in a special cup and a provider looks at its appearance and checks it for signs of conditions that cause hematuria.
Urine culture. You pee in a special cup and a provider checks it for signs of infection.
Urine cytology. You pee in a special cup and a provider checks for any abnormal-appearing cells.
Cystoscopy. A provider inserts a small camera (cystoscope) through your urethra into your bladder to examine your urethra and bladder.
Imaging tests. Noninvasive imaging tests — including an ultrasound, CT scan and MRI — produce images of your urinary system and other organs and structures.

Treatment Options

Here is a concise explanation of the best treatment for hematuria with points:

Treatment for hematuria depends on its underlying cause, determined through medical history, physical examination, and test results.
Infections: Antibiotics are prescribed to eliminate bacterial infections causing blood in urine.
Enlarged prostate: Medications like alpha-blockers and 5-alpha-reductase inhibitors (finasteride, dutasteride) help reduce prostate size and symptoms.
Cancer: Treatment varies based on stage and goals and may include surgery, radiation, chemotherapy, immunotherapy, hormone therapy, or combinations.
Sickle Cell Disease: Disease-modifying drugs like hydroxyurea, pain relief, and antibiotics are used to manage symptoms.
Chronic Kidney Disease: Medications such as diuretics, blood pressure drugs, cholesterol-lowering agents, and erythropoietin for anemia may be needed.
Endometriosis: Hormonal therapies including birth control, GnRH antagonists/agonists, and danazol help control bleeding.
Surgical options may be considered if medications fail, especially for the prostate and cancer cases, often involving multidisciplinary care.

Blood in Urine