Blood in Urine (Hematuria)

What is blood in urine (hematuria)?
Hematuria, or blood in the urine, can be either gross (visible) or microscopic (blood cells only visible through a microscope). Gross hematuria can vary widely in appearance, from light pink to deep red with clots. Although the amount of blood in the urine may be different, the types of conditions that can cause the problem are the same, and require the same kind of workup or evaluation.
What are the causes of blood in urine?
The causes of gross and microscopic hematuria are similar and may result from bleeding anywhere along the urinary tract. One cannot readily distinguish between blood originating in the kidneys, ureters (the tubes that transport urine from the kidneys to the bladder), bladder, or urethra. Any degree of blood in the urine should be fully evaluated by a physician, even if it resolves spontaneously.
Infection of the urine, (often called a urinary tract infection or UTI) stemming either from the kidneys or bladder, is a common cause of microscopic hematuria. Urine is naturally sterile and should not contain bacteria. Kidney and bladder stones can cause irritation and abrasion of the urinary tract, leading to microscopic or gross hematuria. Trauma affecting any of the components of the urinary tract or the prostate can lead to bloody urine. Hematuria can also be associated with renal (kidney) disease, as well as hematologic disorders involving the body's clotting system. Medications that increase the risk of bleeding, such as aspirin, warfarin (Coumadin), orclopidogrel (Plavix), may also lead to bloody urine. Lastly, cancer anywhere along the urinary tract can present with hematuria.
Treatment
Most teens don't need any kind of treatment for hematuria. When it's due to an infection, doctors might treat it with antibiotics. If hematuria is a sign of something more serious — like sickle cell disease — doctors will treat that condition.

If you've been treated for hematuria, your doctor will probably want you to get follow-up tests after treatment to make sure your urine is free of red blood cells. People who get blood in their urine more than once but have no other signs of illness may need urine tests and physical exams every few months for a year and yearly after that as a precautionary measure. If the hematuria goes away, your doctor may still want to check your urine once a year.