Hematuria: What It Is and What It Means

Hematuria, or blood in the urine, is very common and can affect almost anyone … men, women, and children.

While it is not usually something to be alarmed about, it can be a warning sign of a more serious condition. For that reason alone, it should never be ignored. Anyone experiencing blood in the urine should be seen by a doctor to determine the underlying cause.

What Causes Hematuria?

Blood in the urine can come from the kidneys, where urine is made, or it can come from other structures in the urinary tract, such as:

  • Ureters (the tubes from the kidneys to the bladder)
  • Bladder (where urine is stored)
  • Urethra (the tube from the bladder to the outside of the body)

There are two types of hematuria. Gross hematuria occurs when there is enough blood present in the urine that it is visible to the naked eye. It can turn toilet water a pale pink or bright red color. Microscopic hematuria is a result of there being an amount of blood in the urine that can only be seen through a microscope.

Hematuria may occur without any other symptoms. Some underlying causes, however, are associated with additional symptoms that can be moderate to severe, which is another reason to see your healthcare provider.

Common causes of blood in urine include:

  • Bladder or kidney infections
  • Bladder or kidney stones
  • Certain kidney diseases
  • Enlarged prostate (benign prostatic hyperplasia) or prostate cancer
  • Inherited diseases such as sickle cell anemia and cystic kidney disease
  • Certain medications such as aspirin, penicillin, heparin, cyclophosphamide, and phenazopyridine
  • A tumor in the bladder, kidney, or prostate
  • A kidney injury from an accident or sports
  • Vigorous exercise

Sometimes, what appears to be blood in the urine is actually red pigment from other sources such as food dyes, medications, or an excessive amount of beets.

How is Hematuria Diagnosed and Treated?

Because hematuria is a symptom and not a specific condition, there is no standard treatment for it. Rather treatment is aimed at the underlying cause if one can be found.

Your doctor will start by taking a medical history. This will be followed by a urinalysis. Urine tests may include urine cytology, which uses a microscope to look for abnormal cells in the urine. Blood tests may also be ordered. If blood contains high levels of wastes that kidneys are supposed to remove, it could be a sign of kidney disease.

In addition to urine and blood tests, additional tests may include:

  • Imaging tests such as CT, MRI, ultrasound, and intravenous pyelogram (IVP), a special X-ray of the urinary tract that requires dye.
  • Cystoscopy. This involves the insertion of a small tube with a camera into the bladder through the urethra. Tissue samples (biopsy) may be obtained to check for the presence of abnormal or cancerous cells.
  • Biopsy. A small tissue sample is removed from the bladders and examined under a microscope for signs of disease.

If no underlying cause is found during the initial evaluation, follow-up urine testing and blood pressure monitoring may be recommended. When treatment is needed, your doctor will want to recheck your urine after it is completed to see if the blood is gone. The continued presence of blood may result in the need for additional tests, or a referral to a specialist.

If you have blood in your urine, call your urologist. The specialists at Anne Arundel Urology have extensive experience diagnosing and treating this common condition. Our expertise will make a big difference in getting you the right diagnosis and the right treatment as soon as possible.

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