Blood in your urine? Here’s what to know

Gabriel Fiscus, MD

Urology

Noticing a red tinge after using the bathroom can be alarming. Urologist Gabriel Fiscus, MD, explained why it’s best to reach out to your doctor if you see blood in your urine to rule out anything serious.

What causes blood in your urine?

Blood in the urine is referred to as hematuria. If you can see the blood, this is known as gross hematuria. Blood that is only visible under a microscope and detected on a urinalysis is known as microscopic hematuria.

There are many reasons for you to see blood in your urine, and some can be serious. The most frequent reasons include:

• Urinary tract infections
• Enlarged prostate (in an older man)
• Kidney or bladder stones
• Kidney disease
• Bladder cancer
• Kidney cancer
• Trauma

“Most often, no specific cause is found for microscopic hematuria,” Dr. Fiscus said. “If you’re experiencing pain in your flank or bladder, the blood in your urine could be a sign of a kidney stone or infection.”

If you see what looks like blood in your urine, Dr. Fiscus said it’s best to see your doctor. Cancer is found in over 20% of patients experiencing gross hematuria. Only about three or four people out of every 100 with microscopic hematuria are found to have cancer.

How is the cause of blood in the urine diagnosed?

If your doctor finds microscopic blood in your urine, or if you see blood, the doctor will typically order an office cystoscopy, which is a procedure to look inside your bladder with a small camera, and a CT scan with contrast. If no specific cause is found, it’s a good idea to get a urinalysis every year for the next three to five years. If no further microscopic blood in your urine is found, no further workup is needed. If continued blood is found, further tests may be indicated.

When might bloody urine be a sign of something more serious?

Any blood can be a sign that something’s wrong, but there are additional risk factors that can indicate a more serious problem, such as kidney or bladder cancer.

These risk factors include:

• Old age
• Being male
• Visible blood in your urine (gross hematuria)
• Cigarette smoking (past or current)
• Chemicals in the workplace
• Prior pelvic radiation for cancer
• Prior urological disorder or disease
• Pain when urinating
• Chronic urinary tract infections

Consider this your sign to quit smoking today

Smoking is the number one risk factor for bladder cancer. According to the U.S. National Institutes of Health, studies have shown that former smokers are twice as likely to develop bladder cancer compared to nonsmokers, and current smokers are four times more likely.

“Quitting isn’t easy, but it is one of the most important things you can do for your health,” said Dr. Fiscus.

To figure out the specific cause of microscopic or visible blood in your urine, make an appointment with your doctor and ask about a referral to a urologist.