Hematuria means blood in the urine. Microscopic hematuria indicates that the blood is only seen when the urine is examined under a microscope, while gross (or macroscopic) hematuria means that there is enough blood in the urine so that it can be seen with the naked eye. Despite the quantity of blood in the urine being different, the types of diagnoses that can cause the problem are the same, and the workup or evaluation that is needed is identical.

Hematuria is the presence of blood, specifically red blood cells, in the urine. Whether the blood is visible only under a microscope or visible to the naked eye, hematuria is a sign that something is causing bleeding in the genitourinary tract: the kidneys, the tubes that carry urine from the kidneys to the bladder (ureters), the prostate gland (in men), the bladder, or the tube that carries urine from the bladder out of the body (urethra).

Hematuria is the presence of red blood cells (RBCs) in the urine. In microscopic hematuria, the urine appears normal to the naked eye, but examination with a microscope shows a high number of RBCs. Gross hematuria can be seen with the naked eye-the urine is red or the color of cola.

Hematuria may be painless. It may be associated with burring pain in the penis or vagina. If pain is present, there may be pain in the lower abdomen or flank depending on whether an infection of the bladder or kidney is present. Coagulation disorders that prevent normal blood clotting can produce hematuria. There is often bleeding and easy bruising in other locations. Bleeding associated with prostate problems in men may have features of difficulty urinating. Infections that produce hematuria may have frequent need to urinate. There may be fever and chills.

More serious reasons for hematuria include bladder tumors, kidney tumors, and kidney obstruction. It is reasons like these which make it necessary to properly and thoroughly evaluate all hematuria. Several conditions can cause hematuria, most of them not serious. For example, exercise may cause hematuria that goes away in 24 hours. Many people have hematuria without any other related problems. Often no specific cause can be found. But because hematuria may be the result of a tumor or other serious problem, a doctor should be consulted.

The number of potential causes for hematuria are many. Happily, most of the causes do not represent serious or life threatening disease. Some of the common, less serious reasons for hematuria include kidney stones and urinary tract infections. The most common reason for hematuria in a man 50 years of age or older is benign prostate enlargement. A small percentage of the population normally has microscopic hemuturia with no apparent cause.

When there is enough blood to be visible, the urine may look pinkish, red, or smoky brown (like tea or cola). This is called gross or frank hematuria. It takes very little blood in urine to be visible -about one-fifth of a teaspoon in a half quart of urine. A trace amount of blood in your urine is normal. The average person with a healthy urinary tract excretes about 1 million red blood cells (RBC) in the urine each day. This amount of blood is not visible. This is not considered to be hematuria. An abnormal amount of blood in the urine can be acute (new, occurring suddenly) or chronic (ongoing, long term). Acute hematuria can occur just once, or it can occur many times.


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