Blood in the urine: the 3 main aspects to know (causes, symptoms, treatment)
Blood in the urine, also medically known as hematuria, is a symptom that can indicate a wide range of underlying health issues. It can be classified as:
1 gross hematuria: the blood is visible to the naked eye;
2 microscopic hematuria: blood cells are only detected under a microscope during a urine test.
The color of the urine may vary from light pink to dark red or even brown, depending on the amount of blood and how long it has been in the urinary tract.
Early detection and diagnosis are crucial, as some causes of hematuria can lead to serious complications if left untreated. A doctor may recommend urine tests, blood tests, imaging studies, or a cystoscopy to determine the source of the bleeding. Regardless of the cause, noticing blood in the urine should always prompt medical evaluation to ensure proper care and treatment.
In this article, I’ll dive deep into this condition, describing the causes, the symptoms and the treatment related to blood in the urine.
Causes of blood in urine
There are many possible causes of blood in urine, ranging from benign conditions to more serious health issues. One of the most common causes is a urinary tract infection (UTI), which occurs when bacteria enter the urinary system, leading to inflammation and irritation that may also cause the bleeding.
Kidney stones are another frequent cause; these hard mineral deposits can damage the lining of the urinary tract as they move, resulting in visible or microscopic blood in the urine. Vigorous physical activity, especially long-distance running, can sometimes cause hematuria, a condition often referred to as “runner’s hematuria”, likely due to bladder trauma or dehydration.
Other potential reasons for blood in urine include an enlarged prostate (in males), which can compress the urethra and lead to urinary retention and bleeding, or certain medications such as blood thinners, which may increase the likelihood of bleeding in the urinary system. More serious conditions include kidney infections (pyelonephritis), glomerulonephritis (inflammation of the kidney’s filtering units), and cancers of the kidney, bladder, or prostate, which can all present with blood in the urine, especially in older people. Trauma to the kidneys or bladder, recent urinary procedures, and inherited conditions like polycystic kidney disease or sickle cell disease can also be contributing factors.
Sometimes, the blood is not actually from the urinary system but from contamination (for example, menstrual blood in women or bleeding from the rectum). In some cases, especially with microscopic hematuria, no specific cause is identified despite thorough testing, and the condition may be harmless. However, because hematuria can be an early warning sign of serious illness, it should always be investigated by a healthcare provider to determine the exact cause and whether treatment is necessary.
Prostate cancer and blood in the urine
As I wrote in the previous paragraph, one of the causes of blood in the urine can be prostate cancer.
This occurs when the cancer grows and begins to invade nearby tissues or blood vessels in the prostate or urinary tract. While blood in the urine is not a common early symptom of prostate cancer, it may appear in more advanced stages of the disease. It’s important to note that hematuria can also be caused by other, less serious conditions, so further medical evaluation is necessary to determine the exact cause.
I also wrote an article specifically focused on prostate cancer and how to remove it through robotic surgery. Check it out to dive deeper into this topic.
Blood in the urines: the symptoms
The presence of blood in the urine, can present with a variety of symptoms depending on the underlying cause. It’s important to notice that pain is not always present. There are specific occasions in which, for instance, blood in urine presents itself in males or females with no pain, but I want to focus on the symptoms related to blood in urine with pain.
As I already said, the first and most noticeable sign is a visible change in urine color, ranging from pink or red to dark brown, often described as tea or cola colored. This is known as gross hematuria. Other symptoms that may accompany hematuria include pain or a burning sensation during urination, frequent urges to urinate, difficulty urinating, or lower abdominal or flank pain.
If the blood is caused by a urinary tract infection, symptoms may also include fever, chills, and cloudy or foul-smelling urine. In cases of kidney stones, intense pain in the side or back is common. However, it’s important to note that hematuria can sometimes occur without any other noticeable symptoms, which is why routine urine tests can be important for early detection. Regardless of whether other symptoms are present, any sign of blood in the urine should be evaluated by a healthcare professional.
The treatment
And last, I want to talk about how to treat this condition.
The treatment for blood in the urine largely depends on identifying and addressing the underlying cause. Since hematuria is not a disease itself but a symptom, the first step is to determine why the bleeding is occurring. If a urinary tract infection (UTI) is found to be the cause, antibiotics are usually prescribed to eliminate the infection, and symptoms often resolve quickly with proper medication. When kidney stones are responsible, treatment may range from conservative approaches like drinking plenty of fluids and taking pain relievers, to more advanced options such as lithotripsy (a procedure that breaks stones into smaller pieces) or surgical removal, depending on the size and location of the stone.
In cases where hematuria is linked to an enlarged prostate, medications to shrink the prostate or improve urine flow may be used, and in some situations, surgical intervention is needed. If a more serious condition is diagnosed, such as glomerulonephritis (inflammation of the kidney filters), bladder or kidney cancer, or a bleeding disorder, specialized treatment plans are necessary. These may involve long-term medications, immunosuppressive therapy, chemotherapy, radiation, or surgery, depending on the condition and its severity.
The treatment when the cause is not identifiable
For patients with no identifiable cause, often referred to as idiopathic hematuria, treatment might not be required, but regular monitoring with periodic urine tests or imaging may be recommended to watch for any changes over time.
Regardless of the cause, early evaluation by a doctor is crucial. Prompt diagnosis and appropriate treatment can not only resolve the bleeding but also prevent complications and ensure the best possible outcome for the patient’s health.
