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Blood in the Urine (Hematuria)

What Does Blood in the Urine Indicate?

Blood in the urine may at first alarm us, but as the purveyor of our health and longevity, blood in urine is an easy sign to read, exclaiming a call to action. While many medical complications may bring about blood in urine, most of the time, the source of the blood lies within the urinary tract. The urinary system includes the two kidneys, two ureters, bladder, urethra, prostate, and genitals (in men).

When you see blood in the urine (the medical term is hematuria), call your urologist. If you do not have a urologist, call our clinic. Along with hematuria, you may have other symptoms that you should tell the urologist. These symptoms include frequent urination, a burning sensation when voiding, nausea, vomiting, fever, and pain in the back or abdomen. 

Tell your physician if you take any blood thinners such as aspirin or Coumadin or have a bleeding disorder.

There are two categories of hematuria: gross hematuria and microhematuria. As the names imply, gross hematuria is a large amount of blood, which is why you can see it when urinating. Micro hematuria is a condition when you can see blood only with the use of a microscope. You should take both symptoms seriously.

Initially, the urologist will test your urine to help find the cause of the bleeding. A dipstick will immediately give the doctor some information about the composition of the urine. He will send a sample to a lab to see if bacteria may be causing an infection. They may send a specimen of urine to get a urinalysis. It is an even more detailed description of the urine’s composition.

If there is a lot of blood, the urologist will rinse out the bladder. It is done for the formed blood clots do not block the urine from coming out of the bladder. Rinsing or irrigating the bladder will also show the urologist how much bleeding is still occurring.

The urologist may look in the bladder with a cystoscope. The cystoscope is a tiny fiber-optic instrument that easily slides into the urethra and up into the bladder. The urologist can look into an eyepiece to view the urethra and the bladder. You can also view the cystoscopy through camera on the eyepiece. The urologist may take some photos of suspect areas of the bladder, urethra, and prostatic urethra.

A doctor may also ask to collect urine specimen for cytology to check for cancer cells.

A patient may also need to do other tests after the initial visit. They are a kidney ultrasound, intravenous pyelogram (viewing a dye as it goes through your kidneys and ureters with an x-ray), and a CT scan (more detailed X-ray) of your kidneys and ureters.

Hematuria may run the gamut from bright red to a barely noticeable pink, to a brownish tea color, to the unseen blood found on a dipstick when tested in the doctor’s office or when your blood is sent to the laboratory. Other times what appears to be hematuria is simply a discoloration from food (berries, rhubarb, or beets) or medications such as pain meds and laxatives.

Causes of Hematuria

  • Infection anywhere along the urinary tract may cause blood to appear. The terms used to indicate infection and inflammation of an organ end in “itis” (such as cystitis (bladder inflammation), nephritis (kidney infection/inflammation), and prostatitis).
  • Growths in the urinary system include cysts, tumors, enlarged prostate, and diverticuli (pouches or pockets that may grow on the sides of the bladder).
  • Trauma from a litany of physical situations such as falls, car accidents, impact sports, and distance running.
  • Stones may be lodged in your kidneys, ureters, bladder, or urethra, which can rip the tissue, causing bleeding and block urine from coming out.
  • Cancer of the kidney, prostate, bladder, and gentiles will cause bleeding in its mature stages.