Hematuria (Blood in the Urine)

On this page:

• What is hematuria?
• How common is hematuria?
• Who is more likely to develop hematuria?
• What are the symptoms of hematuria?
• What causes hematuria?
• How do health care professionals diagnose hematuria?

What is hematuria?

Hematuria means there is blood in your urine. The two types of hematuria are

• gross hematuria—when you can see the blood in your urine
• microscopic hematuria—when you cannot see the blood in your urine, but it can be seen under a microscope or is found using a urine test called a urinalysis

Urine is produced in the kidneys, then it flows from the kidneys through the ureters to the bladder. When the bladder empties, urine flows out of the body through the urethra.

How common is hematuria?

Hematuria is a common diagnosis in individuals who visit a urologist. Researchers estimate that at least 1 out of 5 people evaluated by a urologist is diagnosed with hematuria. Gross hematuria is less common than microscopic hematuria.

Who is more likely to develop hematuria?

You are more likely to develop hematuria if you

• have benign prostatic hyperplasia (BPH), or an enlarged prostate
• have cancer of the prostate or cancer in a part of the urinary tract
• have calculi, or urinary tract stones
• take certain medicines, including blood thinners, antibiotics, and aspirin or other pain relievers
• do strenuous exercises, such as long-distance running
• recently had a bacterial or viral infection, such as streptococcus or hepatitis
• have a form of kidney disease called glomerulonephritis

What are the symptoms of hematuria?

Gross hematuria makes your urine look pink, red, or brown. Though the color difference may be alarming, it only takes a small amount of blood in the urine to cause a color change. In most cases, gross hematuria does not cause pain or other symptoms. However, you may have bladder or back pain if there are blood clots in your urine. Blood clots can be painful to pass during urination or can cause pain if the clots block the flow of urine.

Microscopic hematuria does not change the color of urine and typically has no symptoms.

What causes hematuria?

Reasons people may have blood in the urine include

• infection in or inflammation of the bladder, kidney, urethra, or prostate
• trauma
• urinary tract stones or a recent urinary tract procedure
• BPH
• vigorous exercise
• sexual activity
• endometriosis

More serious reasons people may have hematuria include

• cancer of the bladder, kidney, or prostate
• blood-clotting disorders, such as hemophilia
• sickle cell disease
• kidney disease involving the glomeruli

How do health care professionals diagnose hematuria?

Health care professionals use your medical history, a physical exam, and urinalysis to diagnose hematuria and help find the cause. As part of the physical exam, your health care professional may perform a digital rectal exam if you’re a man, or a pelvic exam if you’re a woman.

Your health care professional may also order additional tests, such as urinary tract imaging tests, to help find the cause of your hematuria.

Urinalysis

Your health care professional will use urinalysis—or a urine test—to check a sample of your urine for blood. In some cases, your health care professional will test your urine again to confirm the diagnosis of hematuria.

Sometimes blood from a woman’s menstrual period can get into the urine sample, and the test can show that the woman has hematuria when she doesn’t. Women who test positive for hematuria and are menstruating at the time of the test may be asked to repeat the test after menstruation stops.