Blood in urine in older adults

Overview

Blood in urine, also called hematuria, means there is blood in your urine that you can see or that can only be found with a lab test. In older adults, this can be a sign of a health issue, but in many cases it is not a serious problem. It is important to have it checked by a doctor to find out the cause.

Yes, blood in urine is fairly common in older adults. As we age, our urinary system changes and becomes more prone to infections, stones, and other conditions that can cause bleeding.

This mostly affects people over the age of 60. Men are more likely to have causes like an enlarged prostate, while women may have more urinary tract infections. However, anyone can experience blood in their urine.

Symptoms

Common symptoms

• Pink, red, or cola-colored urine
• Urine that looks cloudy or smells bad (if infection is present)
• Pain or burning when you urinate
• Needing to urinate more often or urgently
• Lower back or side pain

Symptoms in children

• Blood in urine in children is less common and may be due to infection or injury. Older adults have different causes.

Symptoms in older adults

• Painless blood in urine can be a sign of bladder or kidney cancer and should always be checked.
• In older adults, an enlarged prostate or weakened bladder muscles may also cause blood to appear.
• Blood thinners (medicines that prevent clots) can sometimes cause blood in urine.

Causes

Main causes

• Urinary tract infections (UTIs)
• Kidney or bladder stones
• Enlarged prostate (in men)
• Kidney or bladder cancer
• Vigorous exercise (though less common in older adults)
• Certain medicines, such as those that prevent blood clots (anticoagulants)
• Trauma or injury to the urinary tract

Risk factors

• Being over 60 years old
• Smoking or a history of smoking
• Long-term use of certain medicines (like blood thinners)
• Repeated or chronic urinary tract infections
• Family history of kidney or bladder cancer
• Having a condition like kidney disease or an enlarged prostate

When to see a doctor

See a doctor urgently if:

• If you see any blood in your urine, even once, make an appointment with your doctor within a few days.
• If you have blood along with fever, pain, or trouble urinating, seek prompt care.

Book a routine appointment if:

• If you have only a small amount of blood that appears and then goes away, still schedule a routine appointment to get it checked.
• If you are on blood thinners and notice blood, talk to your doctor about whether it is safe to continue.

Diagnosis

Your doctor will start by asking about your symptoms and any medicines you take. They will also perform a physical exam and order tests to see where the blood is coming from and why.

Tests that may be done

• Urine test (urinalysis) – checks for blood, infection, and other signs.
• Blood tests – check kidney function and possible infection.
• Ultrasound – uses sound waves to create images of the kidneys and bladder.
• CT scan – more detailed picture of the urinary tract.
• Cystoscopy – a thin tube with a camera is used to look inside the bladder.

What to expect at your appointment

These tests are usually painless, though a cystoscopy may cause some discomfort. Your doctor will explain each step and why it is needed. You may be referred to a specialist, such as a urologist, for further care.

Treatment

Treatment depends entirely on what is causing the blood in your urine. Many causes can be managed with simple treatments, while others may require more care. Your doctor will work with you to choose the best plan.

Self-care at home

• Drink plenty of water to help flush the urinary system (unless your doctor advises otherwise for a medical condition).
• Avoid smoking, as it can worsen many urinary problems.
• Rest if you have an infection or after a procedure.
• Take any prescribed medicines exactly as directed.

Medical treatments

If an infection is found, antibiotics are commonly used. For an enlarged prostate, medicines that relax the prostate or shrink it may be prescribed. Stones can sometimes be treated with medicine to help them pass, or with sound waves to break them up (lithotripsy). If a tumor is the cause, treatment may involve surgery, radiation, or other therapies. Always follow your doctor’s advice about any medicines or treatments.

When is surgery considered?

Surgery may be needed if you have a large stone that cannot pass, a tumor in the bladder or kidney, or an enlarged prostate that does not get better with medicine. Your doctor will explain the options and what to expect.

Living with this condition

If you have had blood in your urine, you may need to see your doctor for follow-up tests until the cause is clear. Keep a record of any symptoms you notice and any changes in your urine color. Stay in touch with your healthcare team.

Lifestyle tips

• Drink enough water to stay hydrated (unless your doctor gives you a fluid limit).
• Do not smoke; if you smoke, ask your doctor about ways to quit.
• Manage high blood pressure and diabetes if you have them, as these can affect kidney health.
• Take all medicines as prescribed, and check with your doctor before taking over-the-counter pain relievers.

Diet and exercise

Eat a balanced diet with plenty of fruits, vegetables, and whole grains. Limit salt and processed foods to help keep your kidneys healthy. Moderate exercise, such as walking or swimming, is generally safe and good for overall health. Ask your doctor before starting new exercise if you have kidney problems.

Mental health and emotional wellbeing

It is normal to worry when you see blood in your urine, especially if you are concerned about cancer. Remember that many causes are not serious. If you feel anxious or stressed, talk to your doctor or a counselor. Joining a support group can also help.

Prevention

Not all cases of blood in urine can be prevented, but you can lower your risk. Staying hydrated, not smoking, and managing chronic conditions like high blood pressure or diabetes can help. Avoid overusing painkillers that can harm the kidneys.

Screening programmes

If you have risk factors such as a family history of kidney or bladder cancer, your doctor may recommend regular check-ups or urine tests. There is no routine screening for everyone, so follow your doctor’s advice.

Complications

If left untreated

• Kidney damage or kidney failure from an untreated blockage or infection.
• Spread of a bladder or kidney infection to the blood (sepsis).
• Delayed diagnosis of cancer, which may reduce treatment options.

Long-term outlook

The outlook for blood in urine in older adults is generally very good, especially when the cause is found early. Most conditions that cause blood in urine can be treated successfully. Even when the cause is more serious, like cancer, early detection leads to better outcomes. With proper medical care, you can continue to live a full and active life.

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