Hematuria (Blood in Urine)
Hematuria is the presence of blood in the urine. Blood may be visible (referred to as gross hematuria) or detected by a urine microscopic examination (known as microscopic hematuria). Regardless of the presentation, hematuria is a sign that there is bleeding in the genitourinary system: the kidneys, ureters, bladder, prostate or urethra.
There are many causes for hematuria in adults. Many causes of hematuria are benign and require no treatment other than observation. The primary purpose of an evaluation is to identify serious or life threatening causes of hematuria with the most concerning of these being urologic cancer. Studies indicate that 1 percent to 3 percent of patients undergoing evaluation of microscopic hematuria are diagnosed with a urologic cancer, though the diagnosis of urologic cancer in patients with gross hematuria is substantially higher.
Hematuria causes the urine to have a pink or red color. Urine can also include clots or a dark brown color.
Blood in the urine may also be intermittent, meaning it could be present or absent from one examination to another.
After a physician determines the patient has hematuria, she/she may order additional studies or refer the patient to a urologist or nephrologist for further evaluation. Complete urologic evaluation includes:
- Urinalysis: A urine sample is taken on a treated chemical stick and examined under a microscope for the presence of red blood cells. The physician may also send your urine to a lab to determine specifically whether bacteria are causing infection.
Radiologic imaging of the kidneys:
- Renal ultrasound
- Intravenous urography (IVU or IVP)
- A CT Scan or MRI
- Urinary cytologic evaluation: A specialized urine examination, in which a urine specimen is collected and sent for testing. A pathologist examines cells in the urine that may be suspect for cancer in the urinary tract.
- Cystoscopic examination: Viewing the urethra and urinary bladder with a specialized telescope. The procedure can be performed with either a rigid cystoscope or a flexible telescope.
Your urologist will make specific recommendations as to which test is preferred based on your situation.
If no serious urologic source for the hematuria is identified the prognosis is excellent. Some patients leak a small amount of blood into the urine but require nothing more than close observation.
To learn more about Hematuria, visit WebMD's Digestive Disorders Health Center.