What is hematuria and is it serious?

Blood in the urine, also known as hematuria, may be a sign of a serious condition or a symptom of something benign, such as a kidney stone. Hematuria could be obvious blood in urine, with or without clots, found during testing, or seen under a microscope.  

Women are more likely to assume blood in the urine is due to a more common condition, such as a urinary tract infection or menstruation, and disregard it. However, because blood in the urine may be the only symptom of a life-threating condition such as bladder cancer, it should never be ignored!

What causes blood in urine?

There are many reasons one could experience hematuria. Blood in the urine may be caused by:

Because of the many possible causes, evaluation by a urologist is key to a quick, accurate diagnosis and appropriate treatment. It’s also important to always follow up with a urologist after an episode of hematuria, even if the urine is clear. 

What does blood in urine look like?

When an individual has hematuria, the blood in the urine may appear dark red, light red or pink in color. Some individuals may have visible blood in their urine while others may have microscopic blood in the urine, meaning the blood in the urine is only visible while looking at it under a microscope and is not visible to the naked eye. 

Can blood in urine go away on its own?

Blood in the urine may come and go or may persist. If blood in the urine clears, it does not mean you are free from concern. Blood in the urine should still be evaluated by a healthcare provider to identify the cause of bleeding and to ensure a serious condition is not present.

Can lack of water cause blood in urine?

Dehydration does not cause blood in the urine, but may cause urine to appear cloudy, darker, concentrated, or odorous. 

Concentrated urine may be irritating to the bladder. Drink water regularly to stay hydrated and to help dilute urine. Flushing the kidneys and bladder daily with 64 ounces of water is critical. Try adding freshly squeezed lemon to water for a tasty treat.

How do you treat blood in urine?

Treatment involves identifying why the bleeding is occurring. If you experience blood in the urine, you should be evaluated by a urologist as soon as possible. No one should ignore this symptom, but especially individuals who are at higher risk for urologic cancers, including: 

  • women
  • cigarette smokers
  • individuals with occupational exposure to chemicals, solvents, arsenic, arylamines or aromatic amines
  • those who have taken the diabetes medication Pioglitazone, also known as Actos. 

Prompt diagnosis and treatment are essential. To evaluate for bladder cancer, a provider will assess for risk factors of urologic disease and order tests such as:

If you are experiencing blood in the urine or other urologic issues, the experts at our Minimally Invasive Urology Institute can help. 

Dragan J. Golijanin, MD

Dr. Dragan Golijanin is a urologist and a director of the Minimally Invasive Urology Institute and director of Genitourinary Oncology at The Miriam Hospital. His areas of expertise include prostate cancer, kidney cancer, bladder cancer and testicular cancer.