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Discovering blood in urine when you urinate can be shocking at first. It is important to take this symptom seriously, even if it does not always have a serious cause. In many cases, the blood is due to a harmless or temporary change, but it can also be a warning sign. We will tell you what blood in your urine can mean and what the next steps are.
Microhematuria vs. macrohematuria: Not all blood in urine is visible
Regardless of the cause, blood in urine is not always visible to the naked eye. Doctors distinguish between macrohematuria, in which the urine is visibly reddish or brownish in color, and microhematuria, in which red blood cells are only detectable under a microscope.
You can see macrohematuria yourself by the color of your urine, but microhematuria can only be detected at home with a urine test strip. It may also be noticed during routine checks when your doctor performs a urine test.
Important: Even if no visible traces of blood in urine are apparent, microhematuria can indicate an organic change or disease. So if you perform a test from a drugstore or pharmacy yourself and it shows a positive result, have it checked out!
Harmless causes of blood in urine
Not all blood in the urine is a sign of a serious illness. In many cases, there are completely harmless or temporary triggers that are easy to treat. Especially if you have been physically exerting yourself, the findings can be alarming at first. It is crucial that you have it checked out quickly.
Typical and harmless causes include:
- Intense physical activity, such as running a marathon
- Mild bladder or urethra irritation due to inflammation
- Injuries during sports activities that put strain on the pelvis
- Medications such as blood thinners (microhematuria)
- Consumption of beetroot, rhubarb, or dyes that color the urine red
If you have eaten foods that stain, your urine will appear red, but a urine test will not show any results. However, please note that a self-test is only an indication and does not replace a diagnosis.
Diseases as a cause of blood in the urine
If blood appears in the urine and does not disappear, this may be a sign of an organic disease. In such cases, hematuria is a symptom of an underlying disease that must be treated. Depending on your age and any accompanying symptoms, there are various possible causes, ranging from infection to tumor disease.
Typical medical causes of blood in the urine are:
- Bladder infections, which cause additional symptoms such as increased urge to urinate and burning in the urethra. A possible route of transmission is uncleaned sex toys such as masturbators, in which germs have multiplied.
- Urethral or kidney infections, which are accompanied by fever and pain in the flank.
- Kidney or ureter stones, which are painful when passing and damage the lining of the urethra.
- Benign enlargement of the prostate, which causes microscopic bleeding due to pressure on the urethra.
- Inflammation of the prostate with pain in the perineal area, fever, and blood in the urine and semen.
- Tumors of the bladder, kidneys, or prostate that do not cause any other symptoms.
- Blood clotting disorders that lead to spontaneous and recurring microbleeds.
- Kidney infarction, in which a blood vessel in the kidney is completely blocked. The kidney may fail completely; severe pain, vomiting, nausea, and blood in the urine are typical signs.
If you are over 50, not only the urinary tract but also the prostate should be examined. Benign, i.e. non-cancerous, enlargement is common at this age and may be accompanied by bleeding. Even in younger people, malignant disease cannot always be ruled out, although the probability is lower.
Urinary tract infection as a cause of blood in the urine: what the doctor will do
Do you feel a burning sensation when urinating, see blood in your urine, and need to go to the toilet more often than usual? These are the typical signs of a urinary tract infection, which, contrary to popular belief, does not only occur in women.
The biggest problem with this otherwise harmless condition is the risk that the inflammation can spread to the prostate and even to the epididymis. If you delay treatment for a urethral infection, the bacteria or viruses can travel up through your urethra and lead to prostatitis.
Typical symptoms include:
- Blood in the urine
- Dull pain in the pelvic floor
- Pain in the perineum and testicles
- Fever and exhaustion
Sometimes the symptoms are only mild, but you feel unwell and weaker than usual. If you do not treat the prostatitis or ejaculate during this time, the inflammation can spread further, even to your epididymis. Epididymitis is extremely painful and is accompanied by severe swelling.
If your doctor suspects a urinary tract infection, they will first examine your urine. They will look for traces of blood, inflammatory cells, and bacteria. Depending on the results, they will then decide whether you need to take antibiotics. If the symptoms recur or there are signs of prostate involvement, an ultrasound or PSA test may be necessary.
Preventing bladder infections and blood in the urine
Not all infections can be prevented, but you can often prevent bladder infections. If you are prone to frequent symptoms or have already had prostatitis, this may be due to certain habits.
It is important to empty your bladder regularly and completely so that germs do not remain in the body for longer than necessary. If you drink little or suppress the urge to urinate, the risk of bacteria colonizing increases. It is also a good idea to urinate after sex, as this simply flushes out any potential germs.
Don’t forget about daily intimate hygiene. If bacteria multiply on your glans, they can enter the urethra and your bladder. You don’t need an arsenal of soaps, but you should wash your best bits and the surrounding areas thoroughly at least once a day.
Tip: For special sexual activities such as clinic play, it is important that your equipment is always hygienic and that you do not share it with others. This will prevent bacteria from being transmitted during sex.
Which doctor can help with blood in urine?
If you discover blood in urine yourself or it is detected during a urine test, your first point of contact should be your family doctor. They can give you an initial assessment, carry out a further microscopic test and, depending on the results, decide whether further investigation is necessary. For men, it is also advisable to see a urologist.
This specialist is specialized in diseases of the urinary tract and male reproductive organs. Using ultrasound examinations, palpation, or even a cystoscopy, they can determine exactly where the blood is coming from and whether it requires treatment. If you have recurring symptoms, refrain from self-medication and seek the help of a specialist. The earlier serious diseases are detected, the better the chances of recovery.