Seeing blood or blood clots when urinating, medically known as hematuria, is a symptom that warrants prompt medical investigation. While alarming, it indicates an underlying issue, not a diagnosis itself. Professional medical attention is always advisable to determine the precise cause.
Understanding Blood in Urine
Blood in urine, or hematuria, refers to the presence of red blood cells in the urinary tract. There are two primary types: gross hematuria and microscopic hematuria. Gross hematuria is when blood is visibly present, making urine appear pink, red, or brown. Blood clots, which can be stringy, jelly-like, or dark red, are a form of gross hematuria.
Microscopic hematuria involves blood cells not visible to the naked eye, detected only through laboratory tests like urinalysis. Both types indicate blood has entered the urinary system. While certain foods or medications can temporarily change urine color, any red or unusual discoloration requires medical evaluation to rule out blood.
Common Causes of Blood in Urine
Blood in the urine can stem from various sources within the urinary tract. A frequent cause is urinary tract infections (UTIs), particularly common in women. Bacteria entering the urethra and multiplying in the bladder can lead to inflammation and irritation, causing red blood cells to leak into the urine. Alongside blood, UTIs often present with symptoms like pain or burning during urination, frequent urges to urinate, and cloudy or strong-smelling urine. Kidney infections, a more severe form of UTI, can also lead to hematuria and may involve fever, chills, and lower back pain.
Another common culprit is kidney stones, which are small, hard mineral deposits that form in the kidneys. These stones can cause bleeding as they move through the urinary tract, potentially scraping the lining and damaging blood vessels. Large stones may obstruct urine flow, leading to significant pain, nausea, and vomiting, in addition to blood in the urine. Even very small stones can cause microscopic hematuria.
In men, an enlarged prostate (benign prostatic hyperplasia or BPH) can cause blood in the urine. An enlarged prostate can press on the urethra, leading to irritation and bleeding from stretched blood vessels. Severe bleeding may result in blood clots.
Certain medications, especially blood thinners like aspirin or warfarin, can increase the likelihood of blood in the urine. Kidney diseases, including inflammation of the kidney’s filtering units (glomerulonephritis), can also cause hematuria. This condition involves damage to the tiny blood vessels within the kidneys, allowing red blood cells to pass into the urine.
Strenuous physical activity, often called “runner’s hematuria,” can temporarily cause blood in the urine. This benign condition typically resolves within 24 to 72 hours, related to activity intensity or minor bladder trauma. However, do not assume exercise is the cause without medical evaluation.
Less common but more serious conditions can also cause hematuria, including cancers of the bladder, kidney, or prostate. Blood in the urine can be an early or even the only symptom of these cancers, requiring prompt investigation. Genetic disorders like sickle cell anemia and polycystic kidney disease are also known to cause blood in the urine.
When to Seek Medical Care
Any visible blood or blood clots in urine warrant medical consultation. Even if bleeding is intermittent or resolves on its own, it should not be ignored, as it may indicate a serious underlying condition. Early detection can prevent worsening of treatable conditions like certain cancers or kidney disease.
Immediate medical attention is necessary if blood in the urine is accompanied by significant pain in the lower abdomen, side, groin, or back. Difficulty urinating, inability to pass urine, or multiple large blood clots are urgent scenarios. Fever, chills, nausea, or vomiting alongside hematuria also indicate prompt evaluation. These suggest an obstruction or severe infection.
Diagnosis and Treatment
Diagnosing the cause of blood in urine typically begins with a comprehensive medical history and physical examination. A urinalysis is a standard initial test, confirming blood presence and checking for infection or other abnormalities. A urine culture may be performed if a UTI is suspected, while urine cytology examines urine for abnormal or cancerous cells.
Imaging tests are frequently used to visualize the urinary tract. An ultrasound of the kidneys and bladder can help identify kidney stones, cysts, or tumors. Computed tomography (CT) scans or magnetic resonance imaging (MRI) may also be ordered to provide more detailed images of the kidneys, ureters, and bladder, looking for masses or other structural issues.
A cystoscopy is a procedure that allows a doctor to directly examine the inside of the bladder and urethra. During this procedure, a thin tube with a camera is inserted through the urethra into the bladder. This enables the clinician to identify the source of bleeding, such as tumors, inflammation, or stones within the bladder lining.
Treatment for blood in urine depends entirely on the underlying cause. Bacterial infections are typically treated with antibiotics. Kidney stones might require interventions from increased fluid intake to procedures for larger ones. An enlarged prostate may be managed with medications or, in some cases, surgical interventions to improve urine flow. If a more serious condition like cancer is identified, treatment involves specific targeted therapies.