Blood in Urine (Hematuria)
Causes of Hematuria
Common causes of blood in urine include:
Sometimes, what appears to be blood in urine is actually red pigment from other sources such as food dyes, medications, or an excessive amount of beets. Doctors refer to this latter cause as "beeturia."
Assessment of Hematuria
Your doctor will start by taking a medical history and asking what may have caused the appearance of blood in your urine. This will be followed by a test called urinalysis. In this test, a urine sample is analyzed.
Urine tests may include urine cytology, which uses a microscope to look for abnormal cells in the urine. Blood tests may also be ordered. If blood contains high levels of wastes that kidneys are supposed to remove, it could be a sign of kidney disease.
In addition to urine and blood tests, you may need additional imaging tests. These may include:
Computed tomography (CT) scan. A CT, which is a special X-ray scan, can help identify bladder or kidney stones, tumors, and other abnormalities of the bladder, kidneys, and ureters.
Kidney ultrasound. An ultrasound uses sound waves to create a picture of the kidney's structure.
Intravenous pyelogram (IVP). This is an X-ray of the urinary tract that requires dye.
Cystoscopy. This test involves the insertion of a small tube with a camera into the bladder through the urethra. Tissue samples (biopsy) may be obtained to check for the presence of abnormal or cancerous cells.
Kidney (renal) biopsy. A small tissue sample is removed from the kidney and examined under a microscope for signs of kidney disease.
Treatment of Hematuria
Treatment is aimed at the underlying cause. After treatment, your doctor will recheck your urine to see if the blood is gone. If you still have blood in your urine, you may need additional tests, or you may be referred to a urologist.
Usually, no treatment is necessary unless a serious condition is causing the hematuria.
If no underlying cause is found during the initial evaluation, you may be advised to have follow-up urine testing and blood pressure monitoring every three to six months, especially if you have risk factors for bladder cancer, such as being age 50 or older, smoking cigarettes, or exposure to certain industrial chemicals.