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Hematuria (Blood in the Urine)

Hematuria is the presence of blood in the urine.  This happens when your kidneys or other parts of your urinary tract allows blood cells to leak into your urine.  Hematuria may be visible to the naked eye (gross) or visible only under a microscope (microscopic) and is usually painless. Although blood in the urine is not always a cause for concern, it may be an indication of an underlying condition in the genitourinary tract that needs further evaluation.  The genitourinary tract includes the kidneys, ureters, bladder, and urethra, as well as the prostate/genitals in men. 


Depending on the underlying condition associated with the hematuria, you may have the following symptoms:  

  • The visible sign of pink, red or cola-colored urine (hematuria) may be only sign. Strenuous physical activity or certain medications may cause bleeding.
  • Pain on your back or the side of your abdomen between the rib and the hip (flank). This may be due to a kidney stone or kidney infection that may cause bleeding
  • Burning/pain when you urinate, or frequent and urgent urination, may be a sign of a urinary tract infection (UTI) or, in some instances, bladder cancer.
  • For men, difficulty urinating.  Having a weak urinary stream or waking up frequently to use the bathroom may be indicative of prostate enlargement, inflammation, or infection that can be source of bleeding.


Age - Men may have blood in urine from an enlarged prostate gland.

Your sex - Younger men are likely to have kidney stones and more than half of all women get a urinary tract infection at least once in their lives, possibly with some urinary bleeding.

A recent infection - Kidney inflammation from infection is one of the leading causes of visible urinary blood in children.

Family history - You have a family history of kidney disease or kidney stones.

Certain medications - Coumadin, Aspirin, non-steroidal anti-inflammatory pain relievers, and antibiotics such as penicillin are known to increase the risk of urinary bleeding.

Strenuous exercise - Long-distance runners are especially prone to exercise-induced urinary bleeding.


Many of the causes of hematuria are non-threatening (benign). However, sometimes it may be the only sign of a serious underlying condition. Causes can include:

  • Stones in the urinary tract ( kidney, ureter, bladder)
  • Infections of the urinary tract (bladder, kidney, prostate in men)
  • Enlarged prostate in men
  • Cancer
  • Kidney disease
  • Kidney Injury
  • Inherited disorders
  • Medications
  • Strenuous exercise
  • Trauma
  • No cause