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Why Do I Have Blood In My Urine?

Updated: Jan 3, 2020

Blood in the urine or "Hematuria" is a common reason for referral to a urologist. There are many causes for this problem which need to be considered. In general any amount of blood in the urine is considered abnormal as the urinary system is a sterile environment where no blood cells are expected. To better characterize and stratify risks of various conditions we consider two types of hematuria, namely "Gross" and "Microscopic".

Gross Hematuria refers to blood in the urine that can be seen with the naked eye.

Microscopic Hematuria refers to blood cells in the urine that are only seen under a microscope.

There are many causes for hematuria. These can be benign (non-cancer) or malignant (cancer related). There also some less serious causes of hematuria such as vigorous exercise, sexual activity, minor infections, kidney or bladder stones, and inflammation along any portion of the urinary tract.

Large stone in the bladder
Bladder Stone

More serious causes may include kidney stones, trauma with damage to the urinary system, blood clots as well as bleeding disorders, sickle cell disease, and cancer of the kidney, ureter, bladder, or urethra.

A bladder tumor discovered on cystoscopy
Bladder Tumor

Risk factors for hematuria include current or past smoking history, exposure to chemicals over an extended time, prior radiation exposure, and recurrent urinary tract infections.

How Is Hematuria Diagnoses?

When you are sent to the urologist for evaluation of hematuria testing may be recommended to further elucidate the cause of the blood in the urine. Your physician may obtain a repeat urinalysis, order blood tests, obtain imaging studies such as CT or MRI scan, and recommend a cystoscopy. Cystoscopy is an endoscopic procedure that allows for direct visualization of your bladder by the surgeon.

What Are The Treatments?

Hematuria is treated based on findings of the testing described above. Your urologist may recommend serial urine examinations or discuss with you additional treatments based on findings of your work up.


As always, the information above is meant to be informative and does not replace your physician's recommendations or judgement. Each individual case has to be evaluated carefully to determine the best course of action. Call or use our contact page to request an appointment to further discuss your unique case.

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