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Should you be concerned about blood in the urine (hematuria)?
– how to remain healthy, health and wellbeing, latest symptoms and treatments.

Should you be concerned about blood in the urine (hematuria)?

Also read: What does your urine say about your health?

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Blood in urine

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  • Usually it is clear that there is blood in the urine because the urine changes color from pink to bright red or even black. Small blood clots may also be present. If the urine is bright red, it is usually a problem with the urinary tract. If the urine has a brownish color, it may be a problem with the kidneys.
  • There can also be blood in the urine without you noticing it yourself. This usually comes to light during a urine test. In that case, it is called invisible or microscopic hematuria.

Also read: 10 things you should know about a bladder infection

Please note: Red urine is not always blood

If your urine looks a little red, it does not always mean that it is blood. Eating beetroot, berries, rhubarb or dyes and some medicines (e.g. laxatives) can cause a pink discoloration of the urine. Such a red discoloration disappears within a few hours to days.

Possible causes of blood in urine

There are many conditions in which blood can occur in the urine. In about 50% of people with detectable blood in the urine and in 70% of people with microscopic hematuria, no abnormality is found.
The most common causes are:
  • heavy physical exertion (especially endurance sports, e.g. a marathon, a rowing competition, etc.)
  • in a woman the blood may come from menstruation;
  • after sexual contact there may be some blood in the urine due to small wounds. In children this can be an indication of sexual abuse;
  • medicines (e.g. painkillers);
  • a urinary tract infection (e.g. due to an STD): this is the most common cause. In about 40% of people with blood in their urine, it is a urinary tract infection;
  • a kidney infection;
  • a benign enlargement of the prostate or prostatitis;
  • kidney stones, or stones in the ureter or bladder;
  • an injury to the urinary tract or kidneys (e.g. after an accident, in contact sports but also in some endurance sports such as mountain biking);
  • a kidney disease, e.g. a kidney infection;
  • a blood clotting disorder (e.g. sickle cell disease);
  • malignant abnormalities: bladder cancer, kidney cancer, prostate cancer. This occurs mainly above the age of 40.

No hematuria due to blood thinners

Blood thinners, or more correctly: anticoagulants, do not cause hematuria. They can, however, cause the bleeding to be heavier and last longer.

Also read: Causes of Strong Smelling and Stinking Urine

When to see a doctor?

Although many cases of hematuria are not serious, you should always consult your doctor when you see blood in your urine, especially if you have other symptoms. Blood in the urine after an accident should also always be investigated further.
  • If you have an infection or inflammation of the urinary tract or bladder, you will usually also have pain when urinating and you will urinate less but more often.
  • With a kidney infection, the same symptoms may occur, but also pain in the back or side and fever.
  • A kidney stone may be accompanied by sudden, severe pain in the back, side or lower abdomen;
  • With kidney disease you may also have general symptoms such as fatigue, loss of appetite and so on.
If your GP cannot find the cause, considers additional examination necessary (e.g. an ultrasound, CT scan or endoscopic examination of the urinary tract or kidneys) or suspects a serious cause, he/she will refer you to a urologist (urinary tract specialist) or nephrologist (kidney disease specialist).

Treatment

Treatment depends on the underlying cause.
  • If no cause is found, in younger people (- 40 years) the urine will be checked again after two to three months.
  • Blood in the urine caused by excessive exertion, minor wounds after sex or menstrual blood usually disappears on its own within a few days.
  • Urinary tract and bladder infections are treated with antibiotics.
  • For stones in the urinary tract or kidneys, the doctor may prescribe an anti-inflammatory, painkiller and an antispasmodic. If necessary, the stones can be surgically removed or crushed.
  • Tumors in the kidneys, ureters, bladder or prostate are treated with radiation therapy, chemotherapy or are surgically removed.
  • A bleeding prostate can be treated with medication. Sometimes surgery is necessary.

Also read: Prostate Inflammation: Symptoms and Treatment of Prostatitis

Sources:

Last updated: September 2023

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