Hematuria (Blood in urine): Causes and symptoms

hematuria diagnosis

Hematuria is the presence of blood or blood cells in the urine. Although blood in the urine is usually not a major problem, it can however be a sign of a serious medical condition and shouldn’t be ignored. All cases of hematuria should be evaluated by a doctor who can order tests to confirm or rule out an underlying cause.

Blood that you can see with your naked eyes is know as gross hematuria. Whiles urinary blood that’s visible only under a microscope is microscopic hematuria. Either way, it’s important to detect the reason for the bleeding.

Hematuria can originate from the kidneys, where urine is produced. It also can come from other structures in the urinary tract, such as:

  • Ureters
  • Bladder
  • Urethra

Causes of hematuria

Various problems can cause blood in urine such as:

  • Urinary tract infections. These occur when bacteria enter your body through the urethra and multiply in your bladder.
  • Cancer. Visible urinary bleeding may be a sign of advanced kidney, bladder or prostate cancer.
  • Kidney stones. The minerals in concentrated urine sometimes form crystals on the walls of your kidneys or bladder.
  • Enlarged prostate.It then compresses the urethra, partially blocking urine flow.
  • Pyelonephritis. These can occur when bacteria enter your kidneys from your bloodstream or move from your ureters to your kidney’s.
  • Injury to the urinary tract. Blunt trauma to the urinary tract or traumatic foley catheter placement
  • Inherited diseases such as sickle cell anemia and cystic kidney disease.
  • Certain medications such as aspirin, penicillin, heparin.

Please note that urine can also change colors due to food choices and dehydration. Foods such as beets, blackberries, and rhubarb, as well as food with a lot of dyes, can cause your urine to change color.

Symptoms of hematuria

  • Frequency of urine
  • Painful urination
  • Urgency of urine
  • Nausea
  • Vomiting
  • Fever
  • Pain in your abdomen
  • Passing pink, red or cola-colored urine due to the presence of red blood cells.

Test and diagnosis

Sometimes the cause of hematuria can be determined based on the medical history and urine testing. Also, the following tests and exams helps in finding a cause for blood in your urine:

  • The first step in evaluation of hematuria is to perform a urine dipstick.
  • Secondly, urinalysis with microscopic evaluation for confirmation.
  • Additionally, physical exam which includes a discussion of your medical history.
  • Furthermore, computed tomography (CT) scan. It helps identify bladder or kidney stones, tumors, and other abnormalities of the bladder, kidneys, and ureters.
  • Moreover, kidney ultrasound. To take picture of the kidney’s structure to determine any abnormality.
  • In addition, intravenous pyelogram (IVP). This is an X-ray of the urinary tract that requires dye.
  • Also, cystoscopy. This test involves the insertion of a small tube with a camera into the bladder through the urethra.
  • Finally, kidney biopsy. A small tissue sample is removed from the kidney and examined under a microscope for signs of kidney disease.


Depending on the condition causing your hematuria, treatment might involve taking antibiotics to clear a urinary tract infection, trying a prescription medication to shrink an enlarged prostate or having shock wave therapy to break up bladder or kidney stones. In some cases, no treatment is necessary.

Be sure to follow up with your doctor after treatment to ensure there’s no more blood in your urine.


About felclinic 593 Articles
Felix Ntifo is a Registered General Nurse who has so much passion to improve health care delivery. He founded FelClinic with the hope of making health information accessible to everyone who may not come in contact with him personally. "At felclinic.com we are very passionate about health and well-being of everyone. Our team is made up of professional doctors, nurses, midwives and lab technicians."

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