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Blood in urine: A cause for concern?

Finding blood in your urine might be alarming, but there are a number of possible, harmless causes. Nevertheless, to rule out serious illnesses, you should always let your doctor determine the cause of  the bleeding.
Urine test with colored stick

Is it blood – or something else?

A red colour in urine doesn’t have to be blood. For example, certain foods can affect the urine’s colour. If you have recently eaten a lot of beetroot, this could be the reason your urine has turned red. If there really is blood in the urine, the medical term for this phenomenon is hematuria. When the urine has red, reddish, pink or brownish tones, it is called gross hematuria. But even if the urine is red in colour, this doesn’t necessarily mean it contains a large amount of blood – it only takes a little blood to make urine red. However, sometimes there can be blood in the urine without it being visible to the naked eye. When the concentration of red blood cells in the urine is so low that it can only be detected by testing in a laboratory, it is called microhematuria.

How doctors test for blood in the urine

If your urine is red, and the discoloration is definitely not due to certain foods, menstruation or medication, always consult a doctor. The doctor will analyse a urine sample to verify if there are red blood cells in the urine. The analysis can also, for example, show whether inflammation values are increased, or if levels of protein in the urine are enhanced. All of these aspects can point the way to further diagnosis. Often, it is not possible to make a clear diagnosis by only examining the urine. In this case the doctor will order further examinations, such as a medical ultrasound of the kidneys or bladder.

Some examples of causes for blood in urine

Blood in the urine can be one of many symptoms of a variety of diseases. Most of these diseases are fairly common and have no malignant course. This means they can either be treated or cured. Possible underlying diseases and causes include:
  • Urinary tract infections. If bacteria enter the urinary tract, the cause of bloody urine can be an infection of the lower urinary tract. Sometimes, the infection can spread further up via the ureter(s) to the kidney(s). Other symptoms, for example, can be pain and burning when urinating, dull pain in the kidney, strong-smelling urine, fever or fatigue. Symptoms will get worse if the bacteria spread further up to the upper urinary tract. Read more about Urinary Tract Infection here. 
  • Bladder or kidney stones. Mechanical irritation from foreign bodies in the urinary tract system can cause blood in the urine. For example, certain urinary components – which usually crystallize and are frequently flushed out – can sometimes form crystals, which over time become small bladder or kidney stones. If they become too big, they stick in the ureter or bladder and can often cause reddish urine and severe pain.
  • Tumours of the bladder, urethra or kidneys (both benign and malignant) could also cause blood in urine. They sometimes lead to increased urination or spasmodic pain in the bladder.
  • Diverticula. When part of the bladder wall or urethra wall is weak for some reason and thereby forms an unwanted pocket that can become infected. One of the symptoms can be bleeding when urinating.  
  • Kidney injury. Traumas of the kidneys or urinary tract (due to falls, blows or other injuries) can cause visible blood in the urine.
  • Extreme physical exertion, such as in a marathon race, can also cause blood in the urine.
  • Side effects of medications or radiation therapy are also sometimes the cause of blood in urine in both men and women.

Different reasons for blood and suspected blood in the urine: men vs women

Blood in women´s urine during menstruation is nothing unusual. For men, blood in the urine can be caused by an infection of the prostate or benign enlargement of the prostate. In prostate cancer, however, blood in the urine is at least not one of the first or the main symptoms. Early stages of prostate cancer usually show no symptoms or signs.

Red blood cells in the urine – what is the treatment?

If blood is detected in your urine, the potential treatment depends on the cause of the bleeding. For example, if the bleeding is caused by a urinary tract infection, it would usually be treated with antibiotics. However, if the bleeding is caused by foreign bodies or stones in the kidneys or bladder, the foreign bodies or stones will often need to be surgically removed – this also applies to tumours. Stones can also be removed using ultrasound, which breaks the stones into small pieces and then flushes them from the bladder.

Blood in the urine and incontinence

As already mentioned, blood in men’s urine can be explained by problems with an enlarged prostate. In benign prostate enlargement or having a prostate inflammation, bloody urine is not the most common symptom –other typical symptoms include a constant urge to urinate, or such a strong urge that you can’t make it to the toilet in time. 
These symptoms are not uncommon. If you have urine leakage, contact a professional who can help discover the cause and recommend the right treatment. For extra support, there are also discreet and easy to use incontinence products available that prevent leakage on clothes and remove unwanted odours.

Bladder weakness due to illness? TENA provides discreet protection

TENA absorbent products are designed to prevent precisely this kind of social isolation. Depending on the level of incontinence, there are different product types designed to suit different life situations. You can find all available TENA products here. 
Is the involuntary loss of urine limited to a few droplets? Or is it smaller or larger amounts of urine? For light incontinence, for example, TENA Lady Discreet Mini liners and pads are suitable. Their asymmetrical shape ensures a tight fit and guarantees discretion and comfort. The absorbent core safely absorbs urine and prevents moisture or odours.
TENA Men products work on a similar principle, but their shape and color are designed specifically for men. They are available in four different thicknesses. If there is a need for extra security over many hours, incontinence pants for men can be a suitable choice. What at first glance looks like regular underwear, with their discreet masculine fit and style, ensures optimal security against leaks to support an active lifestyle.

Audited by Josefine Grandin, District nurse, urotherapist, 2020-02-26

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