Hematuria: The presence of blood in the urine

What is hematuria?

Hematuria is the presence of blood in the urine. This can be caused by a number of different conditions.
Most of the time, the cause of hematuria is not serious and will quickly self-resolve. Strenuous exercise is a cause of hematuria that is not serious. Certain foods (beets, berries, rhubarb) can give the urine a red, blood-like appearance that is nothing to worry about. An enlarged prostate or vaginal dryness can cause blood to be found in a urine test. However, hematuria can also be a symptom of a urinary tract infection or a more serious disorder, including urinary tract cancers, so hematuria should never be ignored.  If you have blood in the urine, it is important to see a doctor. 

Symptoms and Types

It is estimated that one in 10 people will experience hematuria. The blood in the urine is not always visible to the naked eye; it can be microscopic, discovered only when the urine is being checked for other reasons under the microscope. Gross hematuria, the type that can be easily seen, tends to appear as red, pink, or dark brown. It isn’t always painful, it may or may not be associated with other symptoms, and it could be persistent or intermittent. The amount of blood in the urine – or whether it is microscopic or gross – doesn’t necessarily indicate whether the problem is serious – or whether there is a problem at all. Hematuria simply means that somewhere in the genitourinary tract – either in the bladder, the kidneys, the ureters (the tubes that carry the urine into the bladder), the urethra (the tube carrying the urine out of the body), and in men, the prostate – red blood cells are leaking into the urine, requiring further investigation.

Causes of hematuria

Among the most benign causes of hematuria is strenuous exercise – particularly long-distance running, which can cause bladder irritation. Other common causes include certain medications, urinary tract infections (particularly common among women), prostatic enlargement (in middle-aged and older men), kidney and bladder stones, kidney disease, physical trauma to the kidneys, a sexually transmitted disease, and certain inherited disorders such as sickle cell disease and lupus. Hematuria can also be the first sign of prostate cancer, kidney cancer, or bladder cancer.


A physical exam, personal and family history review, and variety of tests may be done to pinpoint the cause of hematuria. These include urinalysis, blood tests, imaging tests, and cystoscopy, which is the use of a tiny fiberoptic camera to visualize the bladder. Sometimes the cause cannot be determined. The goal of work-up is to make sure that urinary tract cancers are not missed. When urinary tract cancers are found early, people do very well. 

If you have blood in the urine, go see a doctor. If a urinary tract cancer is identified, see a urologist who specializes in urological cancers. 

Video about Hematuria: What you really need to know

Hematuria Video

In this video, Dr. David Fishbein Yao walks you through what you need to know about hematuria, and what to expect in the treatment process.

Watch Hematuria Video

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