Blood in your urine is called hematuria1 . The amount may be minimal and only detected with urine tests or under a microscope. In other cases, the blood is visible. It often turns the toilet water red or pink. Or, you may see spots of blood in the water after urinating.
The two types2 of hematuria are:
- gross hematuria—when a person can see the blood in his or her urine
- microscopic hematuria—when a person cannot see the blood in his or her urine, yet it is seen under a microscope
What is the urinary tract?
The urinary tract is the body’s drainage system for removing wastes and extra fluid. The urinary tract includes
- two kidneys
- two ureters
- the bladder
- the urethra
The kidneys are two bean-shaped organs, each about the size of a fist. They are located just below the rib cage, one on each side of the spine. Every day, the kidneys filter about 120 to 150 quarts of blood to produce about 1 to 2 quarts of urine, composed of wastes and extra fluid. Children produce less urine than adults. The urine flows from the kidneys to the bladder through tubes called ureters. The bladder stores urine until releasing it through urination. When the bladder empties, urine flows out of the body through a tube called the urethra at the bottom of the bladder.
What causes hematuria?
Reasons people may have blood in the urine include:
- infection in the bladder, kidney, or prostate
- trauma
- vigorous exercise
- viral illness, such as hepatitis—a virus that causes liver disease and inflammation of the liver
- sexual activity
- menstruation
- endometriosis—a problem in women that occurs when the kind of tissue that usually lines the uterus grows somewhere else, such as the bladder
More serious reasons people may have hematuria include:
- bladder or kidney cancer
- inflammation of the kidney, urethra, bladder, or prostate—a walnut-shaped gland in men that surrounds the urethra and helps make semen
- blood-clotting disorders, such as hemophilia
- sickle cell disease—a genetic disorder in which a person’s body produces abnormally shaped red blood cells
- polycystic kidney disease—a genetic disorder in which many cysts grow on a person’s kidneys
Who is more likely to develop hematuria?
People who are more likely to develop hematuria may
- have an enlarged prostate
- have urinary stones
- take certain medications, including blood thinners, aspirin and other pain relievers, and antibiotics
- do strenuous exercise, such as long-distance running
- have a bacterial or viral infection, such as streptococcus or hepatitis
- have a family history of kidney disease
- have a disease or condition that affects one or more organs
What are the symptoms of hematuria?
People with gross hematuria have urine that is pink, red, or brown. Even a small amount of blood in the urine can cause urine to change color. In most cases, people with gross hematuria do not have other signs and symptoms. People with gross hematuria that includes blood clots in the urine may have bladder pain or pain in the back.
How is hematuria diagnosed?
A health care professional diagnoses hematuria or the cause of the hematuria with:
- a medical history
- a physical exam
- urinalysis
- additional testing
Medical History
Physical Exam
During a physical exam, a health care professional most often tap on the abdomen and back, checking for pain or tenderness in the bladder and kidney area. A health care professional may perform a digital rectal exam on a man to look for any prostate problems. A health care professional may perform a pelvic exam on a woman to look for the source of possible red blood cells in the urine.Digital rectal exam. A digital rectal exam is a physical exam of a man’s prostate and rectum. To perform the exam, the health care professional has the man bend over a table or lie on his side while holding his knees close to his chest. The health care professional slides a gloved, lubricated finger into the patient’s rectum and feels the part of the prostate that lies in front of the rectum. The digital rectal exam is used to check for prostate inflammation, an enlarged prostate, or prostate cancer.
Pelvic exam. A pelvic exam is a visual and physical exam of a woman’s pelvic organs. The health care professional has the woman lie on her back on an exam table and place her feet on the corners of the table or in supports. The health care professional looks at the pelvic organs and slides a gloved, lubricated finger into the vagina to check for problems that may be causing blood in the urine.
Urinalysis
The healthcare professional can test the urine in the office using a dipstick or can send it out to a lab for analysis. Sometimes urine tests using a dipstick can be positive even though the patient has no blood in the urine, which results in a “false-positive” test. The health care professional may look for red blood cells by examining the urine under a microscope before ordering further tests.
Before obtaining a urine sample, the healthcare professional may ask a woman when she last menstruated. Sometimes blood from a woman’s menstrual period can get into her urine sample and can result in a false-positive test for hematuria. The test should be repeated after the woman stops menstruating. The health care professional may confirm the presence of red blood cells by examining the urine under a microscope before ordering further tests.
How is hematuria treated?
Health care professionals treat hematuria by treating its underlying cause. If no serious condition is causing a patient’s hematuria, he or she typically does not need treatment.
Points to Remember
- Hematuria is the presence of blood in a person’s urine. Gross hematuria is when a person can see the blood in his or her urine, and microscopic hematuria is when a person cannot see the blood in his or her urine, yet a healthcare professional can see it under a microscope.
- The causes of hematuria include vigorous exercise and sexual activity, among others.
- More serious causes of hematuria include kidney or bladder cancer; inflammation of the kidney, urethra, bladder, or prostate; and polycystic kidney disease, among other causes.
- People who are more likely to develop hematuria may have a family history of kidney disease, have an enlarged prostate, or have bladder or kidney stones, among other reasons.
- People with gross hematuria have urine that is pink, red, or brown.
- Most people with microscopic hematuria do not have any symptoms.
- Taking a medical history may help a healthcare professional diagnose the cause of hematuria.
- Health care professionals diagnose hematuria with a urine test called urinalysis.
- If two of three urine samples detect too many red blood cells, a healthcare professional may order one or more additional tests.
- Health care professionals treat hematuria by treating its underlying cause.
- Researchers have not found that eating, diet, and nutrition play a role in causing or preventing hematuria.
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Bibliography
- https://medlineplus.gov/ency/article/003138.htm
- https://www.niddk.nih.gov/health-information/urologic-diseases/hematuria-blood-urine
