Hematuria, the medical term for blood in urine, always warrants medical evaluation. This condition can manifest in two ways: gross hematuria, where blood is visible to the naked eye, causing urine to appear pink, red, or even brown; and microscopic hematuria, where blood cells are only detectable under a microscope during laboratory testing. While sometimes harmless, hematuria can indicate various underlying health conditions, some of which are serious and require prompt attention.
Common Infections and Inflammatory Conditions
Urinary tract infections (UTIs) are a frequent cause of hematuria in men. These infections occur when bacteria enter the urethra and travel up into the bladder, leading to cystitis, or even further into the kidneys, causing pyelonephritis. Inflammation of the urinary tract lining, a result of these infections, can lead to bleeding as the irritated tissues become fragile. Typical symptoms accompanying UTIs include painful urination, a frequent urge to urinate, and sometimes fever or lower back pain.
Inflammation of the urethra, known as urethritis, can also contribute to the presence of blood in urine. This condition often results from sexually transmitted infections or other irritations, causing the urethra’s delicate lining to bleed. Seeking medical advice for these symptoms allows for proper diagnosis and treatment with antibiotics, which can often resolve the bleeding.
Kidney Stones and Urinary Tract Obstructions
Kidney stones, hard mineral deposits that form in the kidneys, are another common cause of hematuria. As these stones attempt to pass through the narrow urinary tract, they can cause irritation and abrasion to the delicate lining of the ureters, bladder, or urethra. This mechanical irritation leads to bleeding. The characteristic pain associated with kidney stones, known as renal colic, is often severe and felt in the back or side, sometimes radiating to the groin.
Other forms of urinary tract obstruction can also cause bleeding by irritating the urinary passages. Strictures, which are narrowings in the ureter or urethra, can impede urine flow and lead to pressure and damage to the surrounding tissues. Identifying and addressing these obstructions is important to prevent ongoing bleeding and potential complications.
Prostate-Related and Other Urological Cancers
Prostate-related conditions are a significant cause of hematuria in men, particularly as they age. Benign prostatic hyperplasia (BPH), a non-cancerous enlargement of the prostate gland, can lead to both microscopic and gross hematuria. The enlarged prostate can cause fragile blood vessels to rupture and bleed, especially during urination. BPH-related bleeding should still be evaluated to rule out other serious conditions.
Urological cancers, including bladder, kidney, and prostate cancer, are serious causes of hematuria. Bladder cancer frequently presents with painless gross hematuria, requiring urgent investigation. Similarly, kidney cancer can cause hematuria, often without pain in its early stages. Prostate cancer can also lead to blood in urine, especially in advanced stages or if the tumor obstructs the urethra. Early detection for these cancers is crucial for effective treatment.
Kidney Diseases and Less Common Causes
Various kidney diseases can lead to hematuria by affecting the organ’s filtering units. Glomerulonephritis, an inflammation of the glomeruli, which are tiny blood vessels in the kidneys responsible for filtering waste, can cause red blood cells to leak into the urine. This condition results from immune-mediated damage to the delicate structures of the glomeruli, leading to impaired filtration and the presence of blood and sometimes protein in the urine. Polycystic kidney disease, an inherited condition characterized by the growth of numerous cysts in the kidneys, is another cause; these cysts can rupture and bleed into the urinary system.
Certain medications can also induce hematuria. Blood thinners like warfarin and aspirin, as well as some chemotherapy drugs like cyclophosphamide, can increase the risk of bleeding. Strenuous exercise, sometimes termed “runner’s hematuria,” can cause temporary bleeding due to increased pressure on the kidneys, bladder trauma from repetitive impact, or reduced blood flow to the kidneys during intense activity. Trauma or injury to the kidneys or urinary tract from accidents or impacts can directly damage tissues and blood vessels, leading to bleeding. Blood disorders such as sickle cell anemia or hemophilia, which impair the body’s clotting ability, can also manifest as hematuria.
When to Seek Medical Attention
Any instance of blood in the urine, whether visible or only detected microscopically, warrants prompt medical evaluation. While the cause may be benign, blood in urine can also signal serious underlying conditions, including various cancers, making professional medical advice essential. Self-diagnosis is not appropriate, and delaying evaluation can have significant consequences, especially if a serious condition is present.
A healthcare provider will typically begin by taking a detailed medical history and performing a physical examination. Further diagnostic steps often include urine tests, such as urinalysis and urine microscopy, to confirm the presence of blood and identify other abnormalities. Blood tests may also be ordered to assess kidney function or detect other systemic issues. Depending on initial findings and risk factors, imaging studies like CT scans or specialized procedures such as cystoscopy might be necessary to visualize the urinary tract and determine the source of bleeding.