Hematuria

Hematuria results from bleeding anywhere along the urinary tract, from the kidneys to the urethra. Common causes include urinary tract infections, kidney or bladder stones, and inflammation of the kidney (glomerulonephritis). It may also be caused by an enlarged prostate, vigorous exercise, certain medications, or, importantly, urinary tract malignancy, which must always be excluded.

Hematuria may be visible as pink, red, or brown urine (gross hematuria) or detected only on testing (microscopic hematuria). It is often painless but may be accompanied by burning on urination, urinary frequency or urgency, or flank and abdominal pain depending on the underlying cause.

Evaluation begins with urinalysis to confirm the presence of red blood cells and to look for infection or protein. Further investigation may include urine cytology, imaging of the urinary tract, and cystoscopy to inspect the bladder, particularly where malignancy is a concern.