Hematuria is the medical term for blood in your urine. Several different conditions and diseases can cause hematuria. These include infections, kidney disease, cancer, and rare blood disorders. The blood may be visible or in such small quantities that it can’t be seen with the naked eye. Any blood in the urine should be treated as serious—even if it happens only once. You should make a doctor’s appointment as soon as possible. Ignoring hematuria can lead to the worsening of very serious conditions like cancer and kidney disease. Your doctor can analyze your urine and order imaging tests to determine the cause of the hematuria. He or she can then treat that cause.
Hematuria may be gross or microscopic.
If there is enough blood in your urine that your urine appears pink or red or has spots of visible blood, you have gross hematuria.
When you cannot see the blood because the amount is so small, you have microscopic hematuria. Microscopic hematuria can only be confirmed with a lab test that detects blood or by looking at a sample of urine under a microscope.
There are many possibilities for hematuria. In some cases, the blood may actually be from a different source. Blood can appear to be in the urine when it is really coming from the vagina in women, the ejaculate in men, or from a bowel movement in men and women. If the blood is truly in your urine, there are several potential causes.
Infection is one of the most common causes of hematuria. The infection could be somewhere in your urinary tract, your bladder, or in your kidneys. Infection occurs when bacteria moves up the urethra, the tube that carries urine out of the body from the bladder. The infection can move into the bladder and even into the kidneys. It often causes pain and a need to urinate frequently. There may be gross or microscopic hematuria.
Another common reason for blood in the urine is the presence of stones in the bladder or kidney. These are crystals that form from the minerals in your urine. They can develop inside your kidneys or bladder. If the stones are large, they can cause a blockage that often results in hematuria and significant pain.
In men middle-aged and older, a fairly common cause of hematuria is an enlarged prostate. This gland is just beneath the bladder and near the urethra. When the prostate gets bigger, as it often does in men at middle age, it compresses the urethra. This causes problems with urinating and may result in blood in the urine.
A less common reason for seeing blood in the urine is kidney disease. The kidneys can become diseased and inflamed, causing hematuria. This disease can occur on its own or as part of another disease such as diabetes.
In children aged six to 10, the kidney disorder poststreptococcal glomerulonephritis, which can follow an untreated strep throat infection, may cause hematuria. This disorder can develop one to two weeks after an untreated strep infection. Once common, it is rare today because strep infections can be quickly treated with antibiotics.
Cancer of the bladder, kidney, or prostate can cause blood in the urine. Unfortunately, this is a symptom that often occurs once the cancer is already advanced. There may not be earlier signs of a problem.
Certain medicines can cause hematuria. These include penicillin, aspirin, blood thinners like heparin and warfarin, and a cancer drug called cyclophosphamide.
Less Common Causes
There are a few other causes of hematuria that are not very common. Rare blood disorders such as sickle cell anemia, Alport syndrome, and hemophilia can cause blood in the urine. Strenuous exercise or a blow to the kidneys can also cause blood to show up in the urine.
Because some of the causes of blood in the urine are very serious, you should seek medical attention the first time you see it. Even a small amount of blood in your urine should not be ignored. If you do not see blood in your urine but experience frequent, difficult, or painful urination, abdominal pain, or kidney pain, see a doctor. These may all be indications of microscopic hematuria.
Seek emergency help if you cannot urinate, if you see blood clots when you urinate, or if blood in your urine is accompanied by nausea, vomiting, fever, chills, and pain in your side, back, or abdomen.
Many of the causes of blood in the urine are very serious, and ignoring this symptom can have dire consequences. If the blood is from cancer, ignoring it can lead to an advancement of the tumors to the point that they are no longer treatable. Infections that are not treated can ultimately lead to kidney failure.
If the cause of hematuria is an enlarged prostate, treatment can help reduce symptoms. Ignoring it may lead to discomfort from needing to urinate frequently, severe pain, and even cancer. Ignoring hematuria when you have stones can be very painful. Stones must be passed, but this can be helped along by prescription medications and treatments to break them into smaller pieces.
If you are seeing your doctor for hematuria, there are many questions you will need to answer. Your doctor will ask you about the amount of blood and when you see it during the course of urination. He or she will want to know about your frequency of urination, any pain you are experiencing, if you see blood clots, and what medications you are taking.
Your doctor will then give you a physical examination and collect a sample of your urine for testing. The analysis of your urine can confirm the presence of blood and detect bacteria if an infection is the cause. If no bacteria are found, your doctor may order imaging tests such as a computerized tomography or CT scan, which uses radiation to image your body.
Another possible test your doctor may want to do is a cystoscopy. This involves using a small tube to send a camera up your urethra and into your bladder. With the camera, your doctor can examine the interior of your bladder and urethra to determine a cause of your hematuria.
Preventing hematuria means preventing the underlying causes. To prevent infections, drink plenty of water daily, urinate immediately after sexual intercourse, and practice good hygiene. To prevent stones, drink plenty of water and avoid excess salt and certain foods like spinach and rhubarb. To prevent bladder cancer, do not smoke, limit your exposure to chemicals, and drink plenty of water.