Blood in Urine: Symptoms, Causes, Diagnosis, and Treatment

Blood in urine, also called hematuria can be quite disturbing. The cause of blood in urine can indicate a serious disorder. The blood that you can see in your urine is called gross hematuria.

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Blood that is seen only under a microscope is called microscopic hematuria. It is found when your doctor tests your urine.


In the case of gross hematuria, it produces pink, red or cola-colored urine due to the presence of red blood cells. The bleeding usually isn’t painful. However, it can be quite painful to pass out blood clots in your urine. Bloody urine often occurs without other symptoms.

Causes of Blood in Urine

Your kidneys allow blood cells to leak into urine in hematuria. This leakage can be caused by various problems, including:

  • Urinary tract infections:In cases of UTI, bacteria gain access to your body through the urethra and multiply in your bladder. Symptoms can include burning sensation when passing out urine, persistent urge to urinate, and strong-smelling urine.

For some people, especially older adults, the only sign of illness might be microscopic blood in the urine.

  • Kidney or bladder stone.The minerals in concentrated urine can form crystals on the walls of your kidneys or bladder. These crystals can become small, hard stones over time. The stones are generally painless, so you probably won’t know you have them unless they cause a blockage or are being passed. Bladder or kidney stones can also cause both gross and microscopic hematuria.
  • Kidney infections(pyelonephritis). These occur when bacteria enter your kidneys from your bloodstream or move from your ureters to your kidney(s). Signs and symptoms are often similar to bladder infections, though kidney infections are more likely to cause a fever and side pain.
  • Enlarged prostate. As men get to their middle age, the prostate gland often enlarges and compresses the urethra, thereby partially blocking the flow of urine. Signs and symptoms of an enlarged prostate (benign prostatic hyperplasia, or BPH) include difficulty urinating, an urgent or persistent need to urinate, and either visible or microscopic blood in the urine.
  • Kidney disease. Microscopic urinary bleeding is a common symptom of glomerulonephritis, an inflammation of the kidneys’ filtering system. Glomerulonephritis may be part of a systemic disease, such as diabetes, or it can occur on its own.
  • Visible urinary bleeding may be a sign of advanced kidney, bladder or prostate cancer. Unfortunately, These signs may not be noticed in the early stages, when these cancers are more treatable.
  • The anti-cancer drug cyclophosphamide and penicillin can cause urinary bleeding. Visible urinary blood sometimes occurs if you take an anticoagulant, such as aspirin and the blood thinner heparin, and you also have a condition that causes your bladder to bleed.
  • Kidney injury. A person can notice visible blood in urine after a blow to the kidney from an accident or contact sports.
  • Inherited disorders. Sickle cell anemia causes blood in urine, both visible and microscopic hematuria.

Risk factors

Almost anyone including children and teens, can have red blood cells in the urine. Factors that make this more likely include:

  • Men older than 50 have occasional hematuria due to an enlarged prostate gland.
  • Family history.You might be more susceptible to urinary bleeding if you have a family history of kidney disease or kidney stones.
  • A recent infection.Kidney inflammation after a viral or bacterial infection is one of the leading causes of visible urinary blood.
  • Certain medications.Aspirin, nonsteroidal anti-inflammatory pain relievers and antibiotics such as penicillin are known to increase the risk of urinary bleeding.
  • Strenuous exercise.Long-distance runners are especially predisposed to exercise-induced urinary bleeding.

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When to see a doctor

Ensure you consult your doctor anytime you notice blood in your urine. Some medications, such as the laxative Ex-lax, and certain foods, including beets, rhubarb and berries, can cause your urine to turn red. A change in urine color caused by drugs, food or exercise might go away within a few days.

Bloody urine looks different, but you might not be able to tell the difference. It’s best to see your doctor anytime you see red-colored urine.


A doctor may recommend the following tests and exams in finding a cause for blood in your urine:

  • Physical exam:This is a breakdown of your medical history.
  • Urine tests:If bleeding was discovered through urinalysis, another test may be conducted to check if your urine still contains red blood cells. A urinalysis can also check for a urinary tract infection or the presence of minerals that cause kidney stones.
  • Imaging tests.Often, an imaging test is required to find the cause of hematuria. Your doctor might recommend a CT or MRI scan or an ultrasound exam.
  • This occurs when doctor threads a narrow tube fitted with a tiny camera into your bladder to check the bladder and urethra for signs of disease.

READ ALSO: Coughing Up Blood (Hemoptysis): Causes, Tests and Treatment


Treatment of blood in urine often depends on the underlying condition. Treatment might involve taking antibiotics to clear a urinary tract infection, or trying a prescription medication to shrink an enlarged prostate. A shock wave therapy can also be used to break up bladder or kidney stones.


Image source: Urology sanantonio

Disclaimer: The content provided on is purely informative and educational in nature and should not be interpreted as medical advice. Please use the content only in consultation with an appropriate certified medical doctor or healthcare professional.

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