Blood in Urine (Hematuria): What It Means and When to See a Urologist

Seeing blood in your urine is alarming — and it should always be evaluated. Hematuria, even when painless or appearing only once, can be the first sign of a serious urologic condition including bladder or kidney cancer. Dr. Christopher Vendryes, MD provides thorough hematuria workups for patients across Plantation, Pompano Beach, Coconut Creek, and Delray.

Types of Hematuria

Hematuria is divided into two categories. Gross hematuria is visible blood that turns urine pink, red, or brown. Microscopic hematuria is blood seen only under a microscope on a urinalysis — often discovered incidentally during a routine checkup. Both require evaluation, though gross hematuria carries a higher risk of underlying malignancy.

Common Causes

Hematuria can result from urinary tract infections, kidney stones, an enlarged prostate (BPH), vigorous exercise, certain medications (blood thinners), or trauma. More serious causes include bladder cancer, kidney cancer, ureteral cancer, or kidney disease. Because the cause cannot be determined by appearance alone, a urologic workup is essential.

How Hematuria Is Evaluated

A full hematuria workup typically includes a urinalysis and urine culture, a CT urogram or renal ultrasound to image the kidneys and ureters, and cystoscopy — a quick office procedure using a tiny flexible camera to inspect the bladder. Together these tests identify or rule out the major causes of bleeding.

Risk Factors That Increase Concern

Smoking, age over 35, occupational exposure to dyes or chemicals, prior pelvic radiation, and a history of recurrent UTIs all raise the risk of urologic cancer in patients with hematuria. Men are also more likely than women to have a serious underlying cause.

Treatment

Treatment depends entirely on the cause. Infections are treated with antibiotics, stones with hydration or surgical removal, BPH with medications or minimally invasive procedures, and cancers with stage-appropriate surgical or systemic therapy. The earlier the cause is identified, the better the outcome.