Ultimate Guide to Understanding Hematuria and Its Causes

Hematuria, or the presence of blood in urine, often raises alarm for many people. Seeing blood where it doesn’t belong can be frightening, but understanding what hematuria means, its causes, and when to seek medical advice can help reduce anxiety and promote timely care. This guide breaks down everything you need to know about hematuria, from symptoms to diagnosis and treatment options.

Urine sample showing hematuria with red discoloration

What Is Hematuria?

Hematuria refers to blood in the urine. It can be visible to the naked eye or only detected under a microscope. There are two main types:

• Gross hematuria: Blood is visible, turning urine pink, red, or cola-colored.

• Microscopic hematuria: Blood is not visible but found during laboratory urine tests.

  
  

Blood in urine is a symptom, not a disease itself. It signals that something is affecting the urinary tract, kidneys, or nearby organs.

How Common Is Hematuria?

Hematuria is relatively common. Studies show that microscopic hematuria can be found in up to 13% of the general population during routine urine tests. Gross hematuria is less common but more noticeable and often prompts medical evaluation.

Causes of Hematuria

Blood in urine can result from many different causes. Some are harmless, while others require urgent medical attention. Causes can be grouped by the part of the urinary system involved:

Kidney-Related Causes

• Kidney stones: Hard mineral deposits can scratch the urinary tract lining, causing bleeding.

• Glomerulonephritis: Inflammation of kidney filters can leak blood into urine.

• Polycystic kidney disease: Enlarged cysts in kidneys may rupture and bleed.

• Kidney infections: Infections can inflame tissues and cause bleeding.

• Kidney tumors: Both benign and malignant tumors can cause hematuria.

  
  

Bladder and Urethra Causes

• Urinary tract infections (UTIs): Infections in bladder or urethra often cause irritation and bleeding.

• Bladder stones: Similar to kidney stones, these can damage the bladder lining.

• Bladder cancer: Blood in urine is a common early sign.

• Trauma or injury: Physical injury to the bladder or urethra can cause bleeding.

• Enlarged prostate: In men, an enlarged prostate can irritate the urethra and cause hematuria.

  
  

Other Causes

• Medications: Blood thinners like warfarin or aspirin can increase bleeding risk.

• Strenuous exercise: Intense physical activity can sometimes cause temporary hematuria.

• Menstruation: Blood from vaginal bleeding can mix with urine, mimicking hematuria.

• Inherited disorders: Conditions like sickle cell anemia or Alport syndrome affect blood or kidney function.

  
  

Symptoms That Accompany Hematuria

Blood in urine may appear alone or with other symptoms. These can help identify the cause:

• Pain or burning during urination

• Frequent urge to urinate

• Lower abdominal or back pain

• Fever or chills (suggesting infection)

• Unexplained weight loss or fatigue (possible cancer signs)

  
  

If you notice blood in your urine, note any other symptoms and their timing.

How Is Hematuria Diagnosed?

Doctors use several steps to find the cause of hematuria:

Medical History and Physical Exam

They ask about:

• Duration and amount of blood in urine

• Pain or other urinary symptoms

• Recent injuries or exercise

• Family history of kidney or urinary diseases

• Medication use

  
  

Physical exam may include checking the abdomen and genital area.

Urine Tests

• Urinalysis: Detects blood, infection, or protein in urine.

• Urine culture: Identifies bacteria if infection is suspected.

• Microscopic examination: Counts red blood cells and looks for abnormalities.

  
  

Blood Tests

Blood tests check kidney function and look for signs of infection or inflammation.

Imaging Studies

Imaging helps visualize the urinary tract:

• Ultrasound: Non-invasive and detects stones, cysts, or tumors.

• CT scan: Provides detailed images, especially for stones or tumors.

• MRI: Used in some cases for soft tissue evaluation.

  
  

Cystoscopy

A thin tube with a camera is inserted into the bladder to look for tumors, stones, or inflammation.

When to See a Doctor About Hematuria

Seek medical attention if you notice:

• Visible blood in urine, even if it happens once

• Blood accompanied by pain, fever, or difficulty urinating

• Persistent microscopic hematuria found on routine tests

• History of cancer, kidney disease, or recent injury

  
  

Early evaluation can detect serious conditions and prevent complications.

Treatment Options for Hematuria

Treatment depends on the cause:

• Infections: Antibiotics clear bacterial infections.

• Kidney or bladder stones: Small stones may pass naturally; larger ones might need procedures.

• Enlarged prostate: Medications or surgery can relieve symptoms.

• Tumors: Surgery, chemotherapy, or radiation may be necessary.

• Medication adjustment: Changing blood thinners or other drugs may reduce bleeding.

  
  

Sometimes, no treatment is needed if hematuria is temporary and harmless.

Preventing Hematuria

While not all causes can be prevented, some steps reduce risk:

• Drink plenty of water to flush the urinary tract.

• Practice good hygiene to avoid infections.

• Avoid excessive use of blood-thinning medications unless prescribed.

• Manage chronic conditions like high blood pressure and diabetes.

• Avoid strenuous exercise without proper preparation.

  
  

Living with Hematuria

If you have recurrent hematuria, keep a symptom diary noting:

• When blood appears

• Associated symptoms

• Possible triggers like exercise or medications

  
  

This information helps your healthcare provider tailor diagnosis and treatment.