Hematuria is the condition of having blood in the urine. There are two types: gross and microscopic.
- Microscopic hematuria is when there are red blood cells in the urine that can not seen with the naked eye but visible under microscopy.
- Gross hematuria is when blood is clearly visible and can be an alarming sight.
Both types of hematuria are taken seriously and a complete workup may be required.
Causes
These are some of the potential causes of hematuria:
- Urinary tract infection
- Bladder stones
- Kidney stones
- Kidney disease
- Extreme exercise
- Medications
- Prostate enlargement
- Cancers including but not limited to prostate, bladder, ureter and kidney
- Prior radiation to the pelvis or prostate
Evaluation
History and physical exam
Your provider will ask you questions about urinary symptoms, family history of GU history, history of kidney stones, recent imaging, exposures and smoking history
Imaging studies
A CT scan or ultrasound to assess the kidney and ureters
Urine tests
A urine culture can check for infection and sometimes depending on your risk factors, a urine cytology to look for cancer cells
Cystoscopy
A flexible scope called a cystoscope is inserted into the urethra and advanced into the bladder to look for any abnormalities. This is an awake procedure that takes 1-2 minutes.

