Robert Sterling Hollabaugh, Jr. M.D., FACS

Hematuria, or blood in the urine, is one of the most common conditions that a urologist will evaluate. Blood in the urine is never normal; however, it is very common. Whether it involves grossly bloody urine or just a microscopic trace, the need for evaluation is the same.

A simple “Google” search of “blood in the urine” will give a list of many “not-so-pleasant-to-think-about” diagnoses; however, the vast majority of cases do not involve dangerous or life threatening diagnoses. By far the most common cause of hematuria is a simple urinary tract infection, but it is also very important to remember that traces of blood in the urine may be the only early sign of more complicated underlying diseases, even cancers. Don’t try to convince yourself that the bloody urine is not important. Even if it is painless, and even if it goes away on its own, it is still a significant event and your doctor needs to sort it out.

Many things that cause blood in the urine do so by irritating the lining of the urinary tract. Urologic disorders like urinary infections and stones can aggravate or scratch the lining of the urinary tract and make it bleed. Sometimes this bleeding is associated with pain or other symptoms, but often it has no associated symptoms whatsoever. Whether there are, or are not any associated symptoms, the need for evaluation remains the same.

In addition to urologic causes, certain kidney diseases may cause bleeding or weeping blood cells into the urine. If the filter mechanism of the kidney is diseased, the filter may allow blood cells to pass through the filter into the urine. Diseases such as glomerulonephritis, Berger’s disease, and Lupus (to name a few) may affect the kidney filter and present with hematuria. Typically a nephrologist (doctor that manages medical kidney diseases) rather than a urologist (doctor that manages surgical kidney diseases) will treat these types of problems.

Read More