The term hematuria refers to presence of blood in the urine. People may be frightened by finding blood in their urine but this is rarely a symptom of any life threatening condition. Hematuria needs to be carefully evaluated by a physician so the underlying cause can be detected and treated.
Hematuria may present as obvious bright red blood or the urine may be a reddish brown colour due to the presence of red blood cells. Sometimes, the presence of blood in the urine is not visible and is only detected in the laboratory when urine is being tested for another reason. When blood is visible in the urine, the condition is referred to as macroscopic hematuria, while it is called microscopic hematuria if the blood is not visible.
Whether a person has macroscopic or microscopic hematuria, the blood is a sign that bleeding is occurring somewhere in the urinary tract such as the kidney, bladder, ureters or urethra. Commonly, the blood is a sign of cystitis or another urinary tract infection.
Examples of other causes include kidney stones, sexually transmitted infections such as chlamydia, benign enlargement of the prostate, prostate cancer, bladder cancer and kidney cancer.
To diagnose hematuria, a doctor will take a detailed history of the patient’s symptoms to try and establish the cause of the bleeding. Sometimes, urine can turn reddish or brownish for reasons unrelated to the urinary tract. Eating beetroot can colour the urine a reddish color, for example, as can the use of certain medications such as rifampicin or nitrofurantoin.
In women, diagnosis also involves checking whether the blood is actually coming from the urinary tract rather than from the vagina. A rectal examination may also be performed to rule out the possibility that the blood is coming from the rectum or back passage.