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Hematuria is a term meaning "blood in the urine" and is a sign of a potential underlying urological problem. Gross hematuria is urine that is visibly bloody. Urine color may be pink, bright red, or a dark maroon color. Blood clots may be present in the urine. Microscopic hematuria is blood in the urine seen on microscopic urinalysis. In this situation, the urine may visually appear normal.

Causes of Hematuria

Hematuria has many potential causes including infection, kidney stones, bladder stones, cancers of the kidney, bladder, ureter, and vascular malformations. In rare cases, prostate and urethral cancer can cause hematuria. The most common cause of hematuria in older men is benign bleeding from the prostate. In women, bladder infection (cystitis) is the most common cause. Patients who smoke or have a history of smoking are at a higher risk of kidney, bladder, and ureteral cancers.

Diagnosing Hematuria

The need for evaluation is carefully considered by the urologist. A standard evaluation includes cystoscopy, urine cytology, and imaging of the kidneys. Cystoscopy is an office procedure where the urologist looks into the bladder using a fiberoptic or digital scope. Urine cytology is a "pap smear" of the bladder. The patient's urine sample is sent to the pathologist to evaluate the bladder cells shed into the urine, to distinguish normal and potentially cancerous cells. To evaluate the kidneys, the urologist may order one of several imaging studies, including CT scan, intravenous pyelogram (IVP), or renal ultrasound.

Treatments for Hematuria

Treatment will depend upon findings from the evaluation. In many cases, no abnormalities of the urinary tract are discovered, and observation is recommended.