Hematuria

Hematuria

Hematuria (blood in urine)

Hematuria refers to the presence of blood in the urine. If the blood is visible (appearing pink, red or cola-colored) it is called gross hematuria. Blood that can be detected only when urine is examined under a microscope, is called microhematuria.  Most men with hematuria do not have symptoms. Hematuria can originate from any site along the urinary tract, including the kidneys, ureters, bladder, prostate, or urethra. It increases in frequency with . It.. It age and lifestyle factors such as smoking.

Hematuria has many causes, including vigorous exercise, sexual activity, viral illness, trauma/injury, or infection such as a urinary tract infection (UTI). More serious causes include kidney or bladder stones, cancer in the urinary tract, and medical conditions such as blood disorders, inflammatory conditions, polycystic kidney disease, or sickle cell disease. 

Overall, the chance of cancer among people with hematuria is only 3-4%, but is higher in in those men with risk factors, such as smoking, older age, history of pelvic radiation, and exposure to certain medications and chemicals. Hematuria can also occur after recent urologic procedures or if you are taking anticoagulant medications (blood-thinners such as aspirin).

When microscopic hematuria is identified, the next step is to diagnose the cause. Your physician will take a complete medical history and retest your urine at 48-hour intervals. If two of three urine samples reveal blood, it is important to conduct further tests to make sure that the microhematuria is not related to a serious underlying condition, such as cancer. Likewise, all cases of gross hematuria merit further testing. Hematuria evaluation may include use of cystoscopy—looking inside the bladder with a thin, flexible telescope—to visualize the bladder, and imaging with CT or MRI to visualize the kidneys and ureters. Urine tests include cytology to look for cancer cells in urine and urine culture to rule out infection.

Resources:

American Urological Association Clinical Guidelines: DIAGNOSIS, EVALUATION and FOLLOW-UP OF ASYMPTOMATIC MICROHEMATURIA (AMH) IN ADULTS

Urology Care Foundation: Hematuria

National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC)

Hematuria: Blood in the Urine

  

Related Providers

• Associate Professor of Urology and Epidemiology & Biostatistics, • Chief of Urology, San Francisco General Hospital, • Director, UCSF Male Genitourinary Reconstruction and Trauma Surgery Fellowship, • Residency Program Associate Director
Assistant Professor
Assistant Adjunct Professor of Urology