Seeing blood in the urine can be alarming, but it is a symptom with many possible causes, some minor and others more serious. The medical term for blood in the urine is hematuria. It may appear as pink, red, or cola-colored urine, known as gross hematuria, or it may only be detected under a microscope during routine testing, referred to as microscopic hematuria. Providers at practices like Modern Urologist in New York, New York, and Forest Hills, New York often stress that any instance of blood in the urine deserves medical attention, even if it happens only once.
Hematuria itself is not a disease but rather a sign that something may be affecting the urinary tract. The urinary system includes the kidneys, ureters, bladder, and urethra. Bleeding can originate from any of these structures. While some causes are temporary and easily treated, others require prompt evaluation to rule out more serious conditions, including infections, kidney stones, or cancers of the urinary tract.
Common Causes of Hematuria
Infections, Stones, and Enlarged Prostate
One of the most frequent causes of blood in the urine is a urinary tract infection (UTI). Infections can irritate the lining of the bladder or urethra, leading to bleeding along with symptoms such as burning during urination, urgency, and pelvic discomfort. Kidney infections may also cause fever and back pain in addition to hematuria.
Kidney or bladder stones are another common cause. These hard mineral deposits can scrape the lining of the urinary tract as they move, resulting in bleeding and often significant pain. In men, an enlarged prostate—also known as benign prostatic hyperplasia (BPH)—can also contribute to hematuria. When the prostate enlarges, it may compress the urethra and cause irritation or changes in bladder function. Treatments such as Rezum, Urolift, or Prostate Artery Embolization (PAE) are sometimes considered for bothersome urinary symptoms related to prostate enlargement, depending on individual circumstances.
Less Common but Serious Causes
While many cases of hematuria are linked to noncancerous conditions, blood in the urine can sometimes signal more serious issues. These may include kidney disease, bladder cancer, kidney cancer, or prostate cancer. The likelihood of a serious cause increases with age, smoking history, occupational chemical exposure, or a family history of urinary tract cancers.
Certain medications, including blood thinners, can also contribute to bleeding in the urinary tract. Additionally, strenuous exercise may occasionally cause temporary hematuria, particularly after long-distance running. Even when a seemingly harmless explanation is suspected, proper evaluation is essential to confirm the cause and ensure nothing more concerning is overlooked.
What to Expect During an Evaluation
When a patient reports blood in the urine, the evaluation typically begins with a detailed medical history and physical examination. A urinalysis is often performed to confirm the presence of blood and check for signs of infection or other abnormalities. Additional tests may include urine culture, blood work, imaging studies such as ultrasound or CT scan, and sometimes cystoscopy, a procedure that allows a provider to look inside the bladder with a thin camera.
The specific workup depends on factors such as age, overall health, risk factors, and whether the hematuria is visible or microscopic. In some cases, further evaluation of the prostate may be recommended, particularly if urinary symptoms are present. Identifying the underlying cause allows for targeted treatment and better outcomes.
When to Seek Medical Attention
Any episode of visible blood in the urine should prompt a call to a healthcare provider. Even if there is no pain or other symptoms, it is important not to ignore the sign. Microscopic hematuria discovered during routine testing also warrants follow-up, as it may be the earliest indicator of an underlying issue.
Patients in New York, New York, and Forest Hills, New York who experience hematuria are encouraged to seek timely evaluation and ask questions about potential causes and next steps. Modern Urologist emphasizes the importance of understanding urinary health and recognizing changes early. While seeing blood in the urine can be unsettling, prompt medical assessment provides clarity, reassurance, and a path toward appropriate treatment and long-term well-being.
Resources
Davis, R., Jones, J. S., Barocas, D. A., et al. (2012). Diagnosis, Evaluation and Follow-Up of Asymptomatic Microhematuria in Adults: AUA Guideline. The Journal of Urology.
Grossfeld, G. D., Litwin, M. S., Wolf, J. S., et al. (2001). Evaluation of Asymptomatic Microscopic Hematuria in Adults. Urology.
Sharp, V. J., Barnes, K. T., & Erickson, B. A. (2013). Assessment of Asymptomatic Microscopic Hematuria in Adults. American Family Physician.