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Urine - bloody

Definition

Blood in your urine is called hematuria. The amount may be very small and only detected with urine tests or under a microscope. In other cases, the blood is visible. It often turns the toilet water red or pink. Or, you may see spots of blood in the water after urinating.

Alternative Names

Hematuria; Blood in the urine

Causes

There are many possible causes of blood in the urine.

Bloody urine may be due to a problem in your kidneys or other parts of the urinary tract, such as:

If there is no structural or anatomical problem with your kidneys, urinary tract, prostate, or genitals, your doctor may check to see if you have a bleeding disorder. Causes may include:

Blood that looks like it is in the urine may actually be coming from other sources, such as:

  • The vagina (in women)
  • Ejaculation, often due to a prostate problem (in men)
  • A bowel movement

The urine can also turn a red color from certain drugs, beets, or other foods.

When to Contact a Medical Professional

You may not see blood in your urine because it is a small amount and is microscopic. Your health care provider may find it while checking your urine during a routine exam.

Never ignore blood you see in the urine. Get checked by your provider, especially if you also have:

  • Discomfort with urination
  • Frequent urination
  • Unexplained weight loss
  • Urgent urination

Call your provider right away if:

  • You have fever, nausea, vomiting, shaking chills, or pain in your abdomen, side, or back
  • You are unable to urinate
  • You are passing blood clots in your urine

Also call if:

  • You have pain with sexual intercourse or heavy menstrual bleeding. This may be due to a problem related to your reproductive system.
  • You have urine dribbling, nighttime urination, or difficulty starting your urine flow. This may be from a prostate problem.

What to Expect at Your Office Visit

Your provider will perform a physical exam and ask questions such as:

  • When did you first notice blood in your urine? Has the amount of your urine increased or decreased?
  • What is the color of your urine? Does your urine have an odor?
  • Do you have any pain with urination or other symptoms of infection?
  • Are you urinating more often, or is the need to urinate more urgent?
  • What medicines are you taking?
  • Have you had urinary or kidney problems in the past, or recently had surgery or an injury?
  • Have you recently eaten foods that may cause a change in color, like beets, berries, or rhubarb?

Tests that may be done include:

The treatment will depend on the cause of blood in the urine.

References

Boorjian SA, Raman JD, Barocas DA. Evaluation and management of hematuria. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 11th ed. Philadelphia, PA: Elsevier; 2016:chap 9.

Landry DW, Bazari H. Approach to the patient with renal disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 114.