Patient education: Blood in the urine (hematuria) in adults (The Basics)

Should I be worried if there is blood in my urine? — It can be scary to see blood in your urine. But try to stay calm. Blood in the urine is not usually serious. Still, it is important to see a doctor or nurse. The medical term for blood in the urine is "hematuria."

Blood in the urine can come from the kidneys (where urine is made) or anywhere in the urinary tract (figure 1).

What causes blood in the urine? — Blood in the urine can be caused by lots of problems, including:

●Bladder infection, which often also causes burning or pain when you urinate

●Kidney infection, which often also causes back pain and fever

●Kidney stones, which usually also cause back pain

●Certain kidney diseases

●Intense exercise

●Injury (for example, if you fall off a bike and bruise a kidney)

●Enlargement of the prostate (called "benign prostatic hyperplasia"), which is common in older men

●Cancer of the bladder, prostate, or kidney (cancer is an uncommon cause of blood in the urine, and it usually affects people older than 50)

Sometimes, urine can look as though it is bloody even though it isn't. This can happen if you eat a lot of beets or food dyes, or if you take certain medicines.

Should I see a doctor or nurse? — Yes. See your doctor or nurse if you see blood in your urine, or if your urine is pink, red, brownish-red, or the color of tea.

Sometimes, doctors find blood in the urine when they do a routine urine test. That can happen even if the urine looks normal. It means there are microscopic (trace) amounts of blood in the urine.

Which tests should I have? — Your doctor or nurse will decide which tests you should have based on your age, other symptoms, and individual situation. There are lots of tests, but you might not need any.

Here are the most common tests doctors use to find the cause of blood in the urine:

●Urine tests – Urine tests can show what kind of cells are in the urine. This can hold clues about what might be going wrong.

●Blood tests – Blood tests can show whether your kidneys are working normally, or if you might have certain diseases.

●CT scan – A CT scan is a special kind of X-ray. It creates a picture of the kidneys and urinary tract. Doctors can use it to check for kidney stones and other problems in the urinary tract.

●Kidney ultrasound – A kidney ultrasound is another way to create a picture of the kidneys. Doctors sometimes use ultrasound instead of a CT scan.

●Cystoscopy – Cystoscopy is a procedure that allows the doctor to look inside the bladder. To do a cystoscopy, the doctor inserts a small tube into the urethra, the tube through which urine leaves the body. Then they threads the tube up into the bladder. The tube has a tiny camera that projects images of the bladder onto a screen. If the doctor sees anything unusual, they might take a sample of tissue (biopsy) to look at under the microscope.

●Kidney biopsy – During a kidney (renal) biopsy, the doctor takes a small sample of tissue from the kidney to look at under the microscope. The most common way to get the sample is by inserting a needle straight through the skin in the back and into the kidney.

Should I be treated? — That depends on what seems to have caused the blood in your urine. If you had blood in your urine because you exercised too intensely or because your kidney was bruised, you might not need any treatment. On the other hand, if you have blood in the urine because of a bladder or kidney infection, you will probably need antibiotics.

More on this topic

Patient education: Blood in the urine (hematuria) in children (The Basics)
Patient education: Urinary tract infections in adults (The Basics)
Patient education: Benign prostatic hyperplasia (enlarged prostate) (The Basics)
Patient education: Kidney stones in adults (The Basics)
Patient education: Glomerular disease (The Basics)

Patient education: Blood in the urine (hematuria) in adults (Beyond the Basics)