What is Hematuria?

Published: March 13, 2019
pee cups with text hematuria

Hematuria is the presence of blood in urine. But hematuria is not always visible to the naked eye. In some cases, it can only be found by a doctor examining a urine sample under a microscope.

Two Types of Hematuria. 

Gross hematuria. This is when you can actually see blood in your urine.

Microscopic hematuria. This is when a small amount of blood is in the urine, but you can’t see it without using a microscope.

Who is at Risk1, 2?

Anyone can experience hematuria. However, certain factors or existing health conditions can increase your odds. These include:

  • History of kidney stones
  • A family history of kidney disease
  • An enlarged prostate
  • Cigarette smoking (past or current)
  • Chemical exposure
  • Pelvic area radiation
  • Ongoing or past pelvic disease

What are the Causes1, 2?

There are a variety of causes for blood in the urine. Some are quite common, and many are benign. They include: 

  • Rigorous exercise
  • Menstruation
  • Injuries 
  • Viruses or infections
  • Certain medications including: blood thinners, antibiotics and/or pain relievers

Other more serious causes of hematuria are: 

  • Infection of the prostate
  • Kidney or bladder stones
  • Enlarged prostate
  • Kidney disease or trauma
  • Kidney or bladder cancer
  • Inflammation or swelling of part of the urinary tract
  • Blood clots
  • Sickle cell disease

You shouldn’t panic if you see blood in your urine, but you also shouldn’t ignore it. Visible blood is more likely to be tied to a more serious health condition. In the case of microscopic hematuria on the other hand, there is a lower chance of a link to urological cancers.2


In the case of microscopic hematuria, you may not notice any symptoms. 

If you have gross hematuria, you may notice that your urine is pink, red, or brown. In addition, some patients with hematuria may pass blood clots which can be painful.

Diagnosis & Treatment2

Your doctor will get a thorough look at your medical history and document any symptoms you’re experiencing. Then, they’ll collect a urine sample to determine if in fact you do have blood in your urine. 

If your physician concludes that you have hematuria, they’ll work to determine the cause. Depending on your medical history and symptoms, your urologist may use a combination of the following: 

  • Urinalysis, urine cytology, or urine culture to look for cancer cells, infection, or other signs of disease. 
  • blood test may be ordered, to get a better look at your kidney health. 
  • cystoscopy to examine inside the urethra and bladder. 
  • Kidney imaging tests which can pinpoint any inflammation, stones, blockages or tumors.

In some cases, the cause of hematuria isn’t apparent. If you don’t have a clear, treatable cause, your physician may take a “wait and watch” approach to continue to keep a close eye on your numbers and levels.

If you physician finds a specific cause through testing, he or she will come up with a targeted treatment plan that corresponds to the cause of your hematuria. For example, if an infection is at work, your urologist may simply administer a course of antibiotics. If kidney disease is uncovered, a long-term plan to improve your kidney health may be necessary. And in the extreme case that cancer is determined to be the cause, more immediate and serious treatment will be required. However, if bladder or kidney cancer is found early, it can often be effectively treated. 

The bottom line?

You shouldn’t drag your feet when it comes to addressing hematuria with your physician. Even if you only notice blood once, you should be sure to bring it up with your doctor. Most likely, it’s something that can be easily treated. In the event that the condition is serious, the sooner you begin treatment the better. 

(1) http://www.kidneyfund.org/kidney-disease/kidney-problems/blood-in-urine.html

(2) https://www.urologyhealth.org/urologic-conditions/hematuria

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