15234 Hematuria

Overview

Hematuria is the medical term for blood in the urine. It happens when blood cells leak into your urine, which can happen anywhere along your urinary tract — the kidneys, the tubes that carry urine (ureters), the bladder, or the tube that carries urine out of your body (urethra). Hematuria is not a disease itself. It’s a sign that something is causing bleeding somewhere in your urinary system.

Yes. Hematuria is one of the most common reasons people visit their doctor. It is often harmless, but every case deserves a check-up.

Hematuria can affect people of all ages, including children, adults, and older people. Some causes are more common in certain age groups, but it is not limited to one type of person.

Symptoms

Common symptoms

• Pink, red, or brown-colored urine
• Passing small or large blood clots
• No other symptoms — sometimes blood is only found during a routine test
• Pain or a burning feeling when urinating, if an infection is also present

Symptoms in children

• In children, the most common causes are urinary tract infections and a kidney condition called IgA nephropathy.
• Blood may appear after an illness or without any pain.
• Always take your child to a doctor if you see blood in their urine.

Symptoms in older adults

• In older adults, blood in urine can be a sign of bladder or kidney problems, including an enlarged prostate in men.
• It can also be from an infection.
• Because the risk of serious conditions increases with age, older adults should always have hematuria checked promptly.

Causes

Main causes

• Urinary tract infection (UTI) — an infection in the bladder or kidney
• Kidney or bladder stones — hard mineral lumps that can irritate the urinary tract
• Enlarged prostate gland in men — a non-cancerous condition that can push on the bladder
• Kidney disease or inflammation — conditions like glomerulonephritis
• Certain medicines — for example, some blood thinners or pain relievers
• Strenuous exercise — especially endurance activities like long-distance running
• Injury to the urinary tract or kidneys from an accident or blow
• Cancer of the bladder, kidney, or prostate — more common in older adults, but less common overall

Risk factors

• Being over 40, especially if you are a man
• Smoking, which raises the risk of bladder cancer
• A family history of kidney disease or kidney stones
• Repeated urinary tract infections
• Taking medicines that make bleeding more likely (for example, blood thinners)
• Having an enlarged prostate
• Working with certain chemicals, such as dyes or rubber, which can affect the bladder

When to see a doctor

See a doctor urgently if:

• If you see blood in your urine — even once — contact your doctor within 24 hours.
• If you have visible blood with pain, fever, or other symptoms, seek medical attention the same day.
• If you are pregnant and see blood in your urine, call your midwife or doctor that day.

Book a routine appointment if:

• If hematuria was found during a routine urine test (microscopic), your doctor will want to repeat the test and possibly arrange a check-up within a few weeks.

Diagnosis

To diagnose the cause, your doctor will take a detailed medical history, ask about your symptoms, and perform tests. You may also need a physical examination. Based on that, they will decide which tests are needed.

Tests that may be done

• Urinalysis — a urine sample is looked at under a microscope for blood or signs of infection
• Urine culture — a test to see if bacteria are growing in your urine
• Blood tests — to check how well your kidneys are working
• Ultrasound scan — a painless test that creates pictures of your kidneys and bladder
• CT scan or MRI — more detailed imaging to look for stones, tumors, or other problems
• Cystoscopy — a thin, flexible tube with a camera is inserted into the bladder through the urethra; this is done by a specialist and gives a direct view of the inside of the bladder

What to expect at your appointment

You will likely be referred to a specialist called a urologist if tests suggest something more than a simple infection. Some tests, like a cystoscopy, are a bit uncomfortable but are short. You will be given instructions beforehand. It’s best to ask questions and tell your doctor about any medicines you take.

Treatment

Treatment for hematuria means treating the cause. There is no single treatment for blood in urine itself. After your doctor identifies why you are bleeding, they will recommend a treatment plan that fits your specific situation.

Self-care at home

• Drink enough fluids so your urine is light yellow, unless your doctor tells you otherwise.
• Avoid smoking — it is the biggest preventable risk for bladder cancer.
• Keep a simple diary of when you see blood, whether it hurts, and what you were doing beforehand.
• Do not take any new medicines or supplements without asking a pharmacist or doctor.

Medical treatments

Medical treatments depend on the cause. Infections are usually treated with a course of antibiotics. Kidney stones may pass on their own, or you may need medicine to help you pass them or a procedure to break them up. An enlarged prostate can be treated with medicines or other procedures. If cancer is found, treatment may include surgery, radiotherapy, chemotherapy, or a combination of these. Your doctor will explain each step in plain language and give you time to decide.

When is surgery considered?

Surgery is sometimes needed to remove a stone that can't pass, to remove a tumor, or to treat an enlarged prostate when medicines are not enough. Not everyone with hematuria needs surgery.

Living with this condition

If the cause is a simple infection, you may only need to finish your treatment and you’ll be back to normal. If it’s a long-term condition, you may need regular check-ups. Follow your doctor's advice, keep your appointments, and ask questions whenever you're unsure.

Lifestyle tips

• Stay well hydrated — this helps keep your urine diluted and can reduce irritation.
• Stop smoking, if you smoke — this lowers the risk of bladder problems.
• Limit alcohol, which can irritate the bladder.
• Practice good hygiene to prevent urinary tract infections, such as wiping front to back and urinating after sex.

Diet and exercise

Eating a balanced diet with plenty of fruit, vegetables, whole grains, and lean protein supports your overall health. If you’ve had kidney stones, your doctor may suggest dietary changes, like drinking more water or eating fewer oxalate-rich foods. Regular, moderate exercise is fine and beneficial unless your doctor says otherwise.

Mental health and emotional wellbeing

Noticing blood in your urine can be scary. Anxiety about what it could mean is natural. Talk openly with your doctor about your worries. It can also help to bring a family member or friend to appointments, so you have support and a second set of ears.

Prevention

Many causes of hematuria cannot be prevented, but you can lower your risk of some. Don't smoke, avoid chemicals that may irritate the bladder, stay hydrated, manage blood pressure and blood sugar, and treat urinary infections promptly.

Complications

If left untreated

• An untreated urinary tract infection can spread to the kidneys and cause more serious illness.
• Kidney stones that are left alone can cause a blockage and damage the kidney.
• If blood in urine is due to bladder or kidney cancer, delayed diagnosis can make treatment more difficult.
• Conditions like an enlarged prostate can cause repeated bleeding and bladder problems if not managed.

Long-term outlook

The outlook for hematuria is generally good. Most causes are not life-threatening, and even serious conditions like bladder cancer are often treatable when found early. The key is to get checked and follow your doctor’s plan. Many people go on to live healthy, normal lives.

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