Blood in the urine should never
be ignored. This could be the first sign of a serious condition. In
order to help your doctor with the correct diagnosis, you may try to
provide details such as: Was it associated with pain? Did you see blood
clots? What shape did the clots have? The color of the blood (brown,
cherry, bright red, pink or orange) At what time during urination did
you see blood in the urine (beginning or end of stream or during entire
stream)?
Blood in the urine can present in one of two ways: gross hematuria
(blood that you can see in the urine), and microscopic hematuria (blood
that is only seen when the urine is examined under a microscope). Both
types can have serious causes.
When passing blood in urine is associated with pain, especially
abdominal pain, it could be associated with kidney or ureteral stones.
The pain could be localized to the back, to the side, to the groin, or
the penis in men and the labia in women.
If you are passing different-shaped clots in your stream, they could
represent bleeding from the urethra or prostate (in men). Clots can be
wormlike, and if associated with pain it could represent clots coming
from your ureters(tubes from your kidneys to your bladder).
The color of the urine can be also affected by certain foods or
medications. However, you should always consult your doctor if this
develops.
When the blood in the urine is at the beginning of urination, it most
likely comes from the urethra, (the tube from the bladder to the
outside). Blood throughout urination is most likely from the bladder or
kidneys or ureters (the tubes connecting the kidneys and the bladder).
Blood at the end of your stream may be from the bladder or prostate (in
men).
Causes of blood in the urine vary, from inflammatory conditions to
cancers. Urinary tract infections and kidney, bladder, or ureter stones
are also frequent causes. In men, blood can also come from an enlarged
prostate. Cancer of the urethra, bladder or kidneys also may also show
up as blood in the urine.
Blood in the urine in anyone over the age of 40, especially in people
who smoke, should warrant full urologic evaluation because the most
common cause of blood in the urine in this group of people is bladder
cancer. Before that age, infection may be the cause. However, if gross
hematuria is present, even once, it certainly needs to be further
investigated. In this case full evaluation should be done by a urologist
to rule out cancer or other abnormalities.
Full evaluation includes an x-ray study of your kidneys and bladder,
and cystoscopy. Cystoscopy involves the doctor looking directly inside
your bladder by using a very small camera. If you have blood in the
urine, you should contact your physician immediately. Your doctor then
would possibly determine the cause and refer you to a urologist if
needed.
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