Hematuria simply means blood in the urine. The blood may be visible, so that the urine appears reddish or darker than normal. This is called gross hematuria. If the blood is invisible and is discovered only when a urine sample is examined in a laboratory urine test (urinalysis), the condition is called microscopic hematuria.

Actually, hematuria is more a symptom than a condition in itself, because it has many possible causes. A urinary tract infection, kidney or bladder stones, an enlarged prostate in men, cystitis (a bladder infection, usually in women) or bladder, kidney or prostate cancer can all cause hematuria. Other causes include:

  • An injury that results in a bruised kidney
  • Certain medical conditions, such as sickle cell (abnormal red blood cells) disease
  • Certain medications, such as blood thinners (aspirin and some other pain relief medicines)

And certain foods, such as beets and berries, can make urine appear reddish but don’t cause bleeding.

Only a medical exam can determine the actual cause of hematuria. That’s why it’s important to see your doctor immediately if you see blood in your urine – even once. (Gross hematuria can be present one day and disappear the next. But that doesn’t mean the condition causing it has disappeared.) It’s also why you should have regular medical check-ups, including routine urinalysis.

Diagnosis and Evaluation

If blood is found in your urine, either by you or by your doctor, further tests will be ordered to learn the cause. These tests can be:

  • Urine tests
    Aside from routine urinalysis, tests on urine include:
    • Urine culture–this test looks for the presence of bacteria that cause urinary tract infections
    • Urine cytology–this test looks for abnormal cells in the urine, which can be a sign of bladder or kidney cancer

Urologists at Strong Health are now involved in clinical trials of new urine tests and other non-invasive methods to diagnose bladder cancer. If successful, these tests will be easier for patients and enable earlier detection. To learn more about clinical trials, including how to participate in them, click here.

  • Imaging tests
    A number of technologies can be used to get images of the kidneys and other organs. These technologies include traditional x-rays as well as:
    • Intravenous pyelogram (IVP): This technology is a form of x-ray that allows a urologist to clearly see pictures of the urinary system (kidneys, ureters, and bladder). A special dye (called a “contrast agent”) is injected into a vein in the arm. It passes quickly into the urinary system, making it easier to see abnormalities there.
    • MRI (Magnetic Resonance Imaging): This technology uses large magnets to send magnetic waves through the body, creating computer generated cross-sectional pictures of the organs and areas being examined.
    • CT (Computed Tomography): This technology, popularly known as a CAT scan, uses computers to create detailed, three-dimensional cross-sectional pictures of the organs and areas being examined.
    • Ultrasound: This technology uses sound waves projected into the body to create pictures of the organs and areas being examined.
  • Cystoscopy
    This procedure allows a urologist to look directly into the bladder and urethra. The doctor uses a cystoscope, a thin, telescope-like instrument with a fiber-optic lighting system and a special lens. Local anesthesia is given, then the cystoscope is gently inserted into the bladder through the urethra.


The treatment of hematuria depends on its cause, as determined by the diagnostics tests. For more information about each possible cause of hematuria and how it is treated, click on the specific medical conditions below:

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