Blood in Urine

1 Blood in Urine Summary

Is your pee colored pink, brown, or red? It must be blood in urine, or hematuria, which is not normal and must be seen by the doctor.

Normally, the urine is clear yellow to amber in color and contains none or very few red blood cells only. Blood cause the urine to become brown or reddish in color. However, some cases of hematuria are only detectable in tests.

Sometimes, menses can become mixed with urine that is mistaken for hematuria, but this is okay. On other circumstances, there should be no blood in the urine at all.

Note that consumption of beets may discolor your urine and turn it red, but there are no red blood cells in the urine. Drugs like Rifampicin, certain antibiotics, and Phenytoin may also make the urine red in color, but again tests will show there are no blood cells in the urine.

Blood in urine is considered a symptom, not a separate condition. Several medical problems feature blood in urine as a symptom, hence, the reason why you must go to the doctor if you have it.

Hematuria can be described in more specific terms in the following:

  • Gross hematuria, or the appearance of gross blood or blood clots in the urine.
  • Visible or macroscopic hematuria, or passing out red or brown colored urine.
  • Microscopic or non-visible hematuria, or hematuria that can be detected only with laboratory testing.

The doctor should see any case of hematuria, even if it occurs to you only once. Blood in the urine may occur in normal situations. Long-distance runners and athletes may sometimes experience hematuria as very intense physical activity can literally break down red blood cells and become expelled in the urine.

In many cases, blood in urine is caused by kidney stones. Kidney stones, as its name implies, form in the kidneys and slowly travels down the urinary tract. Sometimes, the kidney stones may wound parts of the urinary tract and draw blood, causing hematuria.

Problems in the kidneys, like infections, contusion of the kidneys due to accidents, or drug-induced kidney complications, can also cause blood in urine. The kidneys form urine by filtering out wastes and water from the blood. Blood can leak from the kidneys and end up in the urine. Upper urinary tract infections involving the kidneys can also be a cause.

Another organ usually involved is the urinary bladder. The urinary bladder collects urine continuously dripping from the kidneys so it will be expelled during urination. Blood in the urine can mean that the bladder has problems like infections, tumors, or cancers.

Urinalysis can easily detect blood in urine, even if it occurs in tiny amounts. Sometimes, hematuria is visible enough. Several different lab tests and imaging tests can help pinpoint the cause of blood in urine.

Treatment is focused on addressing the cause. In most cases, blood in urine is caused by conditions that are not serious, so no treatment is needed.

2 Causes

Blood in urine sometimes occurs in otherwise healthy individuals. It can occur in healthy women in their periods, as sometimes menses can mix with the urine. Athletes, long distance runners, and even bongo drummers may also pass out some blood in their pee.

Extreme physical exertion can grind up blood cells, and the body passes them out in the urine, but this rarely occurs. Passing out blood in urine due to this reasons and happens once or twice only, should not be a cause for concern. However, blood in the urine can be a symptom of other conditions, so you should see your doctor right away.

Urinary tract infections: 

Blood in urine is often caused by urinary tract infections. Infections in the urinary tract occur when bacteria travel up the urine and into the organs, and this is more common in females than males.

The infection may cause bleeding in the areas of the urinary tract, causing blood in urine. Urinary tract infections are very common. If left untreated, it can result in recurrent infections, permanent deformities of the urinary tract, or even sepsis (a life-threatening infection of the whole body).

Kidney stones: 

Blood in the urine may sometimes occur in individuals with kidney stones. Some people may pass out stones without a problem while others experience blood in urine. Kidney stones form when minerals in the urine crystallize together to form a stone.

Kidney stones have sharp edges, which can scrape the insides of the urinary tract that might draw blood and cause hematuria. Kidney stones are painful and sometimes can take years to pass out. Dehydration, obesity, high intake of meat, corn syrup and grapefruit juice can make you prone to kidney stones.

Prostate problems:

In men, blood in urine can be one of the early symptoms of enlarged prostate. The urethra passes through the prostate gland. In some men, the prostate gland may grow in size as they age causing pressure on the urethra and blockage of urine flow.

The prostate can also have an infection (prostatitis). Both problems can cause microscopic or macroscopic hematuria. Prostate problems should be treated before it cause stricture of the urinary tract, which results in urine retention and increased the risk of infection.

Medications:

Taking certain medications can cause blood in the urine. Cyclophosphamide and penicillin may cause blood in urine in some users. Drugs that thin the blood, like Aspirin and Heparin, may cause blood to leak into the urine. If you experienced blood in urine caused by drugs, you must report it to the doctor.

Injuries:

Injuries, such as those sustained in sports activities, certain occupations, or car accidents, can also be a cause. Injuries in the kidneys, bladder, and other organs in the pelvis can cause passage of blood in the urine.

Other conditions:

Blood in the urine can be a feature of genetic disorders such as sickle cell anemia and Alport syndrome. Rarely, blood in urine is a telltale symptom of kidney or bladder cancer.

3 Diagnosis and Treatment

Blood in urine should be diagnosed early because it is often a symptom of something wrong. The doctor may start by first asking about other symptoms, such as pain while urinating, difficulties passing out urine, or if blood in urine happens only sometimes or all the time.

It is important that you describe whether blood in urine occurs at the beginning or end of the urine stream, or if it happens the entire time while urinating.

You have to describe your medical history with specifics such as pre-existing conditions, previous treatments, and medications taken. Your doctor also has to do a physical examination and, most importantly, request a urinalysis.

Urinalysis is accurate in detecting even few blood cells in the urine. Sometimes, the doctor may request a sample of your urine and culture it in the lab to determine culprit microorganisms.

Imaging tests are used to determine the cause of bleeding. X-rays is usually not routinely used because organs usually appear clear in the film. Preferred imaging tests include CT (computerized tomography) scan and MRI (magnetic resonance imaging), which produce clear images of the organs and help pinpoint the problem.

Another imaging procedure is cystoscopy, which requires you to be sedated and sit on the bed for a while. Cytoscopy inserts a tiny camera right into the urethra to visualize the inside of the urinary bladder. Sometimes, the ultimate cause of bleeding in the urinary tract may not be found in these procedures.

Treatment for blood in urine depends on the cause. There is no exact drug or procedure to treat bleeding in the urinary tract. If the cause is urinary tract infections, which is very common, your doctor may prescribe oral antibiotics to address the infection. Kidney infection is serious due to the risk of losing the kidney, so it is treated with oral or injected antibiotics.

If the cause stones in the urinary tract, your doctor may encourage drinking more fluids so you can pass it out. If the stone is too large, your doctor may resort to sound wave therapy (extracorporeal shock wave lithotripsy or ESWL) or surgery to remove it. These treatments may still cause bleeding in the urine for few days, but this is okay.

If the cause is kidney injuries, it should be treated immediately. Doctors can now treat kidney injuries without resorting to surgery. The doctor may drain collected blood or seal points of bleeding, which is accomplished by inserting a catheter into the kidney. If the patient is still not stabilized, the doctor has to fix the injured kidney using surgery.

Surgery may be the option if the cause is enlarged prostate gland or cancers. In the case of the prostate gland, surgery may be needed to prevent blockage of urine flow that can increase the risk for infection.

Prostate surgery is usually performed using a technique called transurethral resection of the prostate (TURP), in which the instruments are inserted into the tip of the penis so there is no need for incisions. For cancer in the kidney or bladder, surgery is performed to remove cancerous tumors and chemotherapy or radiation is then instituted to kill remaining cancer cells.

Top