Some Causes and Features of Blood in the Urine
Cause | Common Features* | Tests† |
|---|---|---|
Benign prostatic hyperplasia (noncancerous enlargement of the prostate gland) | Mainly in men over 50 Often difficulty starting urination, a weak urine stream, a sensation of incomplete urination, or dribbling at the end of urination An enlarged prostate detected during a digital rectal examination | Blood tests to measure the PSA level Often ultrasonography of the bladder to measure how much urine remains in the bladder after voiding (postvoid residual urine volume) |
Mainly in people over 50 or with risk factors for these cancers (smoking, family members who have had cancer, or exposure to chemicals that may cause cancer) Sometimes burning or pain during urination or an urgent need to urinate Often symptoms that affect the whole body (such as fever, chills, weight loss or sweating) | Examination of the interior of the bladder using a flexible viewing tube inserted through the urethra (cystoscopy) Possible bladder biopsy Sometimes CT or MRI If prostate cancer is suspected, prostate biopsy | |
Cystitis (bladder infection) | Usually in women and girls A frequent and urgent need to urinate Burning or pain during urination Getting up at night to urinate Sometimes blood in the urine or foul-smelling urine | A doctor's examination Usually urinalysis and urine culture |
Injury | Usually an obvious injury | Usually CT of the abdomen and pelvis |
Kidney filtering disorders (glomerular disorders, such as glomerulonephritis) | Sometimes high blood pressure and swelling in the feet or legs Sometimes protein in the urine, malformed red blood cells, clumps of red blood cells, and/or decreased kidney function Possibly red or dark (cola-colored) urine Sometimes occurring after an infection Sometimes in people who have family members with a kidney or a connective tissue disorder | Urinalysis Blood tests |
Long-lasting pain in the flank or abdomen High blood pressure Sometimes enlarged kidneys detected on an imaging test done for another reason or during a doctor's examination | Ultrasonography Often CT or MRI of the abdomen | |
Mainly in men over 50 Sometimes a lump in the prostate detected during a digital rectal examination Occasionally a weak urine stream, difficulty starting urination, and dribbling at the end of urination | Blood tests to measure the PSA level If the PSA level is elevated, biopsy of the prostate | |
Prostatitis (infection of the prostate gland) | Often fever, difficulty starting urination, frequent urination, the need to urinate during the night, and burning or pain during urination Often symptoms of a long-standing blockage in the urinary tract (including a weak urine stream, difficulty passing urine, or dribbling at the end of urination) In an acute infection, an enlarged, tender prostate detected during a digital rectal examination; in chronic prostatitis, there may not be any significant symptoms | A doctor's examination Urinalysis and urine culture Sometimes transrectal ultrasonography or cystoscopy |
Usually in people already known to have sickle cell disease Mainly in people of African or Mediterranean descent Often in children and young adults | Blood tests to check for abnormal hemoglobin in red blood cells | |
Severe pain in the lower back side (flank) that occurs suddenly or pain in the abdomen or groin that comes in waves Sometimes the urge to urinate but an inability to do so Sometimes vomiting | CT or ultrasonography of the kidneys, ureters, and bladder | |
* Features include symptoms and the results of a doctor's examination. Features mentioned are typical but not always present. | ||
† Tests include urinalysis in all people, blood tests to evaluate renal function in most people, and imaging of the kidneys and pelvis in most older people. | ||
CT = computed tomography; MRI = magnetic resonance imaging; PSA = prostate-specific antigen. | ||