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Hematuria: what causes blood in the urine?


The presence of blood in the urine is medically called hematuria. If the cause is often benign, additional examinations are essential to clarify the origin of the bleeding.

Dr. Charlotte Tourmente

Written on 29/06/2022Updated 29/06/2022


Hematuria: what causes blood in the urine?
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Blood in the urine: should you be worried? —
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Hematuria can be macroscopic, in other words in sufficient quantity to be visible to the naked eye thanks to a pink, red or brown coloration (depending on the quantity of blood, the duration of the presence in the urine and the acidity of this one). We speak of microscopic hematuria when it is not visible.

To establish the diagnosis, it is useful to understand when the bleeding occurs: at the start of urination (raising suspicion of an origin in the prostate or urethra), at the end of urination (the origin is rather at the level of the bladder), or during the entire urination (which involves the kidneys).

Read also : The superpowers of urine!

Several causes of this bleeding

The red color is not always related to the presence of blood. It can occur following the absorption of foods, such as beets, rhubarb or food coloring. In these cases, the color is very temporary.

Certain medications can also cause the staining: phenazopyridine, or sometimes methyldopa, rifampicin, etc.

The red color can also be explained by the presence of hemoglobin. A number of benign conditions may then be involved: a urinary tract infection, prostatitis, urinary stones (in the kidneys, bladder, urinary tract), anatomical malformation.

In rare cases, it can be benign prostatic hyperplasia, kidney cysts, bladder, prostate or kidney cancer, etc. Serious causes are more common in older people.

After a serious fall, damage to the kidneys or bladder can lead to bleeding in the urine.

Finally, the presence of muscle protein or a condition called porphyria can also cause urine to turn red to brownish red in color.

How to react ?

If hematuria is accompanied by certain signs, such as great pain or an inability to urinate, it is imperative to consult urgently.

To define the origin of the bleeding, several examinations are possible. A urine analysis (ECBU), with a culture will be used to detect an infection. Cystoscopy (bladder endoscopy) in people over 50 or those with a risk factor for bladder cancer and PSA testing in men over 50 can also be done.

To assess the functioning of the kidneys, blood tests, or even a kidney biopsy, are carried out. An ultrasound, an MRI or an angio-scanner are sometimes necessary.

The treatment will be prescribed depending on the origin of the bleeding. If a blood clot obstructs the urinary tract and prevents urination, a urinary catheter will be inserted to remove the clot.

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