Hematuria (Blood in Urine)

Types of hematuria

Gross hematuria

If you can see the blood in your urine, you have gross hematuria. The blood can present as pink, red, purplish-red, brownish-red or tea colored.

Microscopic hematuria

Microscopic hematuria is typically found in a urine test during a physical exam because it can’t be seen with the naked eye. When the urine sample is viewed under the microscope, an increased number of red blood cells can be seen.

Causes of hematuria

There are a variety of causes for blood in the urine including:

• Bladder infection
• Kidney infection
• Kidney stones
• Vigorous exercise
• Benign prostatic hyperplasia (enlarged prostate)
• Bladder, prostate or kidney cancer

Your urine can also appear red after consuming food dyes, beets or certain medications.

Risk factors for hematuria

People of all ages can find blood in their urine. Factors that make you more likely to develop this condition include:

• Age — people over 50 years old are more likely to find blood in their urine.
• Gender — men are more likely to develop hematuria.
• Ethnicity — Caucasians are more likely to develop hematuria during their lifetimes.
• Smokers — people who smoke or have a long history of smoking are more likely to develop hematuria.
• Exposure to chemicals, cancer treatments or other irritants — exposure to chemotherapeutic agents, radiation or occupational chemicals can increase your likelihood of developing hematuria.
• Strenuous activity — people who participate in endurance sports, such as long-distance runners, are more likely to find blood in their urine.

Symptoms of hematuria

The most obvious sign of hematuria is visible red, pink or purplish blood in the urine. If you are passing blood clots, it may be painful.

Diagnosis of hematuria

Your primary care doctor can typically diagnose hematuria during a physical exam. If you have gross hematuria, it will be evident when examining the urine sample. Microscopic hematuria can be diagnosed with a urine test (urinalysis).

To determine the cause of hematuria your doctor may order the following tests:

• Urinalysis - can test for the presence of minerals that cause kidney stones.
• Imaging tests - CT scan or MRI test can determine the cause of hematuria. 
• Cystoscopy - evaluates for urinary disease through a camera inserted into the bladder.

Treatment for hematuria

Treatment for blood in the urine varies depending on the cause of the condition. For example, if you have a UTI, your doctor will prescribe an antibiotic. If you have benign prostatic hyperplasia, you may need medication to reduce the size of the prostate.

Recovery from hematuria

Depending on the cause, hematuria typically clears after treatment. It is important to follow up with your doctor even after the blood is gone or if the cause of your condition was not found.