Seen once is enough to check
Blood in the urine: finding the cause
Pink, red or cola-colored urine, or blood found on a routine test, should be checked, even if it clears up on its own. Most causes are treatable. Our urologists find the reason and explain it plainly.
What is hematuria?
Hematuria means blood in the urine. Gross hematuria is blood you can see, while microscopic hematuria is found just on a urine test; both deserve an evaluation.
What is microscopic blood in the urine?
It is blood that shows up when a urine sample is examined under a microscope but can’t be seen in the toilet. It is often found during a routine checkup. A dipstick result by itself can be a false alarm, so we confirm it, then ask about infections, stones, medicines, exercise and smoking before planning next steps. Finding it more than once, or once in someone who smokes or used to, is reason for a urology visit.
What causes blood in the urine?
Common causes include urinary infections, kidney and bladder stones, an enlarged prostate and kidney disease. Less often, blood in the urine is a sign of bladder or kidney cancer, which is why the work-up matters.
Blood thinners can make bleeding more noticeable, but they do not explain it on their own.
When should I see a urologist about blood in my urine?
Book a visit if you see blood even once, or if a test shows blood more than once. Go to the ER if you pass large clots, cannot urinate or have fever with bleeding.
What does a hematuria evaluation involve?
The usual evaluation includes a urine test and culture, imaging of the kidneys and bladder with CT or ultrasound, and cystoscopy, in which a slim scope lets the urologist view the bladder lining. Urine cytology, which checks for abnormal cells, is sometimes added.
Dr. Dev Mally walks through each step, including what the urine culture and imaging look for, in our guide to blood in the urine.
How is blood in the urine treated?
Treatment depends on the cause. Infections are treated with antibiotics, stones and an enlarged prostate have their own treatments, and cancers are treated by stage and type. See our pages on kidney stones, enlarged prostate and bladder cancer.
Who is more likely to have a serious cause?
Smoking, older age, exposure to some workplace chemicals and a history of urologic conditions raise the chance of a serious cause. That is why our urologists do a full evaluation even when bleeding stops.
Is there a video about blood in urine?
Yes. This short video is from the official Advanced Urology channel.
Watch: #001 - Hidden Clues: Understanding Blood in the Urine What the video covers: A podcast episode on microscopic hematuria, blood in the urine that is visible just under a microscope, and the causes it can point to, such as infection, kidney stones or cancer.
Which of our urologists see patients for this?
These urologists list it on their Advanced Urology profiles and see patients in Snellville or Conyers.
- Jitesh Patel, MD · Snellville
- A. Dev Mally, MD · Snellville
- Moshe Shapiro, MD · Snellville
- Marc Greenstein, DO · Conyers
Physician assistants and nurse practitioners who help with it: Jordon Blackmon, PA-C. They are not urologists.
Which articles go deeper on this?
Short answers from Advanced Urology on the questions we hear most.
What do people ask us about blood in urine?
If the blood went away, do I still need to be checked?
Yes. Blood that appears once and clears still deserves an evaluation.
Can blood thinners cause blood in the urine?
They can make bleeding more noticeable, but there is usually another cause, so you still need an evaluation.
What is a cystoscopy like?
For a blood-in-urine evaluation, our urologists do it under anesthesia at an Advanced Urology surgery center, so you are asleep for the few minutes it takes and go home the same day.
Can exercise cause blood in the urine?
Strenuous exercise, such as long-distance running, can. It still needs to be checked.
What if my urine test showed blood but I saw none?
Microscopic blood also deserves an evaluation, especially if it is found more than once.
Where is the evaluation done?
Urine tests happen at your visit, imaging is arranged as part of your work-up, and cystoscopy is done at our surgery center in Snellville.
More from Advanced Urology: Blood in urine · Cystoscopy
Related care: Blood in urine guide · Bladder cancer · Kidney stones · Kidney cancer · All care
Where we see you: Snellville office and surgery center · Conyers clinic · What to bring and insurance
Ready to talk it through?
Get to know our team, then give us a call. We’ll gladly find a day and time that work for you.