Hematuria - Blood In Urine

Hematuria is the medical term for the presence of blood in the urine. This may be visible to the naked eye (gross hematuria) or seen only under the microscope (microscopic hematuria). The blood may come from anywhere along the urinary tract including: the kidneys, ureter, bladder, prostate (men only), or urethra. You should notify your doctor immediately if you see blood in your urine, even if it only occurred one time.

Causes

Hematuria has a number of potential causes, many of which are benign. However, it may be the only sign of a serious underlying medical condition such as cancer. Causes include:

  • Tumors (kidney, ureter, bladder, prostate, urethra)
  • Urinary tract infection
  • Kidney Stones
  • Benign Prostatic Hyperplasia (BPH) / Enlarged Prostate
  • "Idiopathic" - no cause found
  • Trauma
  • Vigorous exercise
  • Sexually transmitted diseases
  • Kidney diseases
  • Medications
  • Viral infection
  • Sickle cell anemia (inherited blood disorder)
  • Systemic lupus erythmatosus (SLE)

Note: certain foods (e.g. rhubarb, beets, food coloring, etc.) can make the urine appear pink without actual blood being present. Dehydration and/or liver disease can darken the urine and this can often be mistaken for blood.

Diagnosis

In addition to a thorough history and physical, your doctor may order any of the following tests to determine the possible source of bleeding:

  • Urinalysis / Urine Culture
  • Urinary Cytology / FISH
  • KUB / Plain X-ray of the abdomen
  • Renal / Bladder Ultrasound
  • CT scan / CT Urogram
  • Cystoscopy
  • Prostate Specific Antigen (PSA) – in men only

Treatment

Your urologist will discuss the findings with you and develop an appropriate plan depending on the underlying cause. If no specific cause is found, the condition that caused bleeding may have corrected itself or may have been "idiopathic" (no specific cause found). Follow-up may still be necessary based upon risk factors and findings. It important to note that while the workup may not initially find a cause, any future visible bleeding should be reported to your doctor.

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