Any sign of blood in your urine can be worrying. If you notice it, you may immediately begin to wonder, “What does blood in urine mean?”
Sometimes it’s obvious because your urine looks red, pink, or brown. Other times, it’s microscopic and only detected during a routine test.
Either way, blood in the urine, known as hematuria, isn’t something to ignore. While the cause may be harmless, it can also be a signal that something needs treatment.
What Does Blood in Urine Mean?
Hematuria is the medical term for the presence of red blood cells in your urine. It falls into two main categories:
- Gross, or visible hematuria. You can clearly see blood in the urine, which may appear pink, red, or cola-colored.
- Microscopic hematuria. Blood is present, but not visible to the eye. It’s usually found during urinalysis and confirmed by viewing red blood cells under a microscope.
But keep in mind, red or brown urine isn’t always caused by blood.
Certain foods like beets, medications, or even muscle injury can change urine color. For this reason, when blood is suspected, further testing is needed.
How Is Blood in the Urine Detected?
Most often, hematuria is first detected through a urine dipstick test, which is highly sensitive to heme. Heme is a component of red blood cells. A positive result should always be followed by microscopic examination to confirm whether red blood cells are actually present.
If the dipstick shows positive results, but no red blood cells appear under the microscope, the color change could be from other pigments. These include myoglobin from muscle breakdown or some medications.
What Causes Hematuria?
Hematuria can result from a wide range of conditions. Some are minor and temporary, while others are more urgent and require prompt treatment. Common causes include:
- Urinary tract infections (UTIs). Infections of the bladder or urethra can cause irritation and bleeding.
- Kidney or bladder stones. Hard mineral deposits can irritate the lining of the urinary tract, leading to bleeding and pain.
- Benign prostatic hyperplasia (BPH). An enlarged prostate in older men can cause microscopic or visible blood in the urine.
- Vigorous exercise. Strenuous physical activity can cause a condition known as exercise-induced hematuria. It typically resolves on its own.
- Menstruation or recent sexual activity can lead to temporary contamination of the urine with blood.
More serious causes may include:
- Bladder or kidney cancer. Hematuria can be a warning sign of a tumor, especially in people over age 50.
- Glomerulonephritis. This is an inflammation of the kidney’s filtering system and is often accompanied by protein in the urine, elevated blood pressure, and worsening kidney function.
- Injury or trauma to the kidneys, bladder, or urethra.
- Medications. Blood thinners, like warfarin or aspirin, certain antibiotics, and chemotherapy drugs, can cause bleeding.
- Lupus and other autoimmune conditions can affect the kidneys and lead to hematuria.
Is All Hematuria Dangerous?
Not necessarily. Many cases, especially those linked to temporary issues like exercise or mild infections, will resolve on their own. However, persistent or unexplained hematuria needs evaluation
Your doctor will begin by reviewing your symptoms, medications, medical history, and risk factors such as:
- Smoking
- Family history of kidney problems
- Underlying health issues
A typical workup may include:
- A repeat urinalysis to confirm if hematuria is persistent. In most cases, two out of three positive samples over several weeks are used to confirm true microscopic hematuria.
- A urine culture to look for infection.
- Blood tests to assess kidney function and check for signs of inflammation or anemia.
- Ultrasound, CT urogram, or MRI may be used to evaluate the kidneys and urinary tract.
- A small camera inserted into the bladder via the urethra to check for growths or bleeding sources. This test is called a cystoscopy.
- Post-void residual urine measurement, especially in men with BPH or those who can’t fully empty the bladder.
If glomerular disease is suspected, your doctor may perform more tests. They will also check for proteinuria, elevated creatinine, and abnormal red blood cell shapes under the microscope.
When Is Hematuria an Emergency?
While most cases of hematuria are not urgent, you should seek immediate medical care if you:
- Are unable to urinate or pass clots and feel bladder pressure or pain
- Have visible blood in your urine along with flank pain, fever, or chills
- Show signs of blood loss like weakness, dizziness, pale skin, or a racing heart
- Have a sudden loss of bladder control
Hematuria with pain, clots, or systemic symptoms could point to a serious condition like a urinary blockage or kidney infection, and quick action can make all the difference.
Get Care for Hematuria
If you’ve been noticing hematuria and wondering, “What does blood in urine mean?”, don’t delay getting care. A urologist is skilled at determining the cause of hematuria and getting you the treatment you need.
Don’t continue to live with hematuria – call (541) 334-3350 to schedule an appointment today!