Blood in your urine can occur due to many causes, including an injury, an underlying condition affecting your kidneys or prostate, a urinary tract infection (UTI), and more. Here’s what we know and when to contact a doctor.
Blood in the urine (hematuria) can happen to anyone, but some causes specifically affect cisgender males and others assigned male at birth (AMAB).
Even with no pain, blood in urine can occur due to a few causes, ranging from easily treatable to more serious. Let’s take a look at these causes and when to contact a healthcare professional.
Injury to any part of the urinary tract can cause blood in the urine. This can include a blunt or penetrating injury to the kidneys or genitals during contact sports, a car accident, or straddle injuries to the penis or testicles.
Blood in the urine may be the only symptom of a kidney injury.
An injury that affects the urethra or testicles may also cause:
Treatment will depend on the type of injury and can include:
- anti-inflammatory drugs to reduce inflammation and pain
- a catheter if you have trouble passing urine
When the bacterium E. coli gets into the urinary tract through the urethra, this causes UTIs. UTIs affect around 20% of the male population, and the risk increases with age.
UTIs can cause blood in the urine and any of the following symptoms:
- cloudy urine
- pain or burning when you pee
- frequent urination
- sudden urge to pee
- lower abdominal pain, usually just above your pubic bone
A course of antibiotics ranging from
A kidney infection is a type of UTI that begins in the lower portion of the urinary tract and makes its way up to one or both kidneys. Getting treatment for kidney infections can prevent serious health conditions, such as high blood pressure, chronic kidney disease, and kidney failure.
Kidney infection symptoms include:
- frequent, painful urination
- cloudy or bloody urine
- nausea and vomiting
- back, flank, or groin pain
Treatment for kidney infection may include:
- antibiotics you can take by mouth, an intravenous fluid (IV), or both
- IV fluids
- surgery if a kidney stone or enlarged prostate blocks your urinary tract
Bladder and kidney stones are more common in people who are AMAB than in cisgender women and others assigned female at birth. They form when certain chemicals in your urine crystallize, forming hard stones ranging from as small as a grain of sand to as big as a golf ball.
Small stones can sometimes pass through urination, but larger stones can get stuck in the bladder or a kidney.
Bladder and kidney stones can cause blood in your urine, but other symptoms vary between locations.
Other symptoms of bladder stones include:
- lower abdominal pain
- painful urination
- only passing small amounts of urine
Other symptoms of kidney stones include:
- sharp pain in the back, side, lower abdomen, or groin
- painful urination
- frequent urge to urinate
- only passing a small amount of urine
- nausea or vomiting
For a small stone, your clinician may recommend drinking more water to help the stone pass on its own.
Other treatments for bladder and kidney stones include:
- medication to help dissolve the stone(s)
- ureteral stenting, which involves a flexible tube that a doctor inserts through the urethra
- nephrostomy, which uses a flexible tube from the kidney to an external bag to help urine flow
- ureteroscopy, a procedure that uses a camera called a cystoscope to find and either remove or break up the stone
The prostate, which is a walnut-sized gland just under the bladder, tends to grow with age. As it gets bigger, it can sometimes put pressure on the urethra, causing urinary symptoms. Unless a tumor or infection makes the prostate larger, an enlarged prostate is known as benign prostatic hyperplasia (BPH).
Along with blood in your urine, an enlarged prostate may also cause:
- frequent urination
- often peeing at night (nocturia)
- urinary urgency
- weak urine stream
- urinary flow that stops and starts
- bladder leakage or incontinence
Treatment for BPH depends on the severity of your symptoms and may include:
- watchful waiting with annual checkups until symptoms become bothersome
- medication to shrink the prostate or relax the muscles near the prostate
- minimally invasive procedures to reduce the size of the prostate or relieve pressure
- prostatectomy, which is prostate removal surgery
Blood in the urine may also result from one of these less common causes:
- Medication side effects: Blood in the urine can sometimes be a side effect of certain medications, such as blood thinners and some chemotherapy drugs. Long-term use of nonsteroidal anti-inflammatory drugs can also cause it.
- Vigorous exercise: Exercise-induced hematuria is often microscopic and not obvious to the naked eye. The amount of blood relates to the intensity of the exercise, so visible blood is more likely after strenuous or vigorous exercise, like long-distance running.
- Inherited genetic conditions: Some inherited conditions, such as sickle cell disease, polycystic kidney disease, and Alport syndrome, can cause hematuria.
- Cancer: Though blood in the urine more likely occurs due to another condition, it can occur from cancer. Painless blood in urine is the most
common symptomof bladder cancer. It can also result from kidney cancer and prostate cancer. These cancers can also cause urinary symptoms similar to UTI symptoms, weight loss, and fatigue.
Even with no pain, blood in urine always warrants contacting a healthcare professional to find the cause of the bleeding. Prompt diagnosis and treatment can help you feel better faster and reduce the risk of complications. In the case of cancer, early diagnosis can make cancer easier to treat.
Get emergency care if you have:
- trouble urinating
- blood clots when urinating
- urine with blood, along with vomiting, fever, or severe back, side, or abdominal pain
Blood in the urine without pain can have a few potential causes, many of which aren’t serious, but it can be a symptom of a bigger health condition. If you see blood in your urine — even just a little — consult a healthcare professional.
Adrienne Santos-Longhurst is a Canada-based freelance writer and author who has written extensively on all things health and lifestyle for more than a decade. When she’s not holed-up in her writing shed researching an article or off interviewing health professionals, she can be found frolicking around her beach town with husband and dogs in tow or splashing about the lake trying to master the stand-up paddle board.