Dear Dr. Garner,
I am very scared. When I got up to go to the bathroom today, my urine looked bloody. It really doesn’t hurt. It is more the sight of it that bothers me.
I am 58 years old, and aside from smoking, I am fine. I have no health problems.
Do you think I have cancer? I am afraid to even call my doctor for an appointment. I am hoping it just goes away.
How worried should I be?
Red Urine in Red Hook
Dear Red Urine,
Bleeding in the urine is known as hematuria, and there are two types of hematuria. In one type, the urine looks normal and a microscope is required to detect the blood cells. In the second type, there is bleeding that changes the color of the urine, and is known as gross hematuria.
In some cases the bleeding may go away on its own. An example of this is urine in the blood that comes from strenuous exercise.
It takes very little blood to cause the urine to change colors. It usually isn’t painful and there may be no other symptoms present. Blood can come from any part of the urinary system, which includes the kidneys, bladder and ureter (tubes that carry urine from the kidneys to the bladder) and in men, the prostate, as well.
Common Causes
Some causes of blood in the urine include:
- Urinary tract infections.
The symptoms present include an urge to urinate, pain or burning with urination and a peculiar smell to the urine.
- Bladder or kidney stones.
The stones can cause either gross or microscopic blood in the urine, and usually has pain associated with it.
- Enlarged prostate.
There may be difficulty urinating, whether gross or microscopic blood is in the urine. Infection of the prostate known as prostatitis can cause the same signs and symptoms.
- Kidney diseases.
Certain infections can cause the kidney cells to inflame. With the swelling of the kidney, the blood vessels become swollen as well, and blood can leak into the urine.
- Cancer.
Yes, the dreaded “c” word can be a cause, although not that common.
- Kidney injuries.
This usually happens as a result of a car accident, fall or sports injury. There can be microscopic blood or bright red bleeding in the urine.
- Medication.
Aspirin, penicillin, heparin blood thinners, and certain anti-cancer drugs can cause blood in the urine.
- Strenuous exercise can cause gross or microscopic bleeding.
- Certain medications or food can cause the urine to change colors. Examples of this are beets, berries and rhubarb. There is no blood in the urine in this instance.
It is important to see your doctor at once should you see any evidence of blood in the urine.
System Overview
To help diagnose the cause, your doctor may order urine tests as well as a CT scan, sonogram or MRI, to get a good look at the whole urinary system. Sometimes the doctor will use a mini camera that goes directly into the bladder to determine if there are any tumors, infection, or pre-cancerous growth.
The treatment for hematuria will depend on the underlying condition. For example, an infection of the kidneys would be treated with antibiotics. Sometimes no treatment is necessary and the condition resolves on its own.
The bottom line is that your bleeding is most likely not caused by cancer, but you do need to have the problem checked.
Best of luck and please keep me informed of your condition.
Dr. Garner is a Fidelis Care provider who is affiliated with New York Methodist Hospital, Park Slope. He also hosts “Ask the Doctor” on NET-TV, Tuesdays at 8 p.m. on Time Warner Channel 97 and Cablevision Channel 30.
