Blood in Urine: What is it? What Do You Need to Know?

by Dr. Alex Shteynshlyuger


If you have any questions about blood in urine, to schedule a consultation or if you need a second opinion, please contact us or call  1 (646) 663-5515


Blood in Urine: See Bloody Urine – See a Urologist.

Blood in urine Blood in urine refers to the presence of red blood cells in urine. Hematuria is a medical term that is synonymous with and literally means “Blood in urine”.

Blood in the urine can be visible to the eye and may appear as pink or red discoloration of urine.  When blood is visible to the eyes, it is called ‘gross hematuria’.  Gross hematuria is easy to spot and diagnose by the color of the urine. The urine can be pink, brownish or red.

Brown urine can be caused by blood in urine, diet or certain kidney problems.

What is “Microscopic Hematuria”?

It may not be obvious but you may have a situation when to the eye, the urine looks yellow and fairly normal. Yet under the microscope, one can see many red blood cells in urine which can be abnormal.  This is what we call “microscopic hematuria”.  Most commonly, patients are told by their primary care doctor that they have blood in urine but the urine looks yellow.  This is called ‘microscopic hematuria”.

What is “Trace of Blood in Urine”?

Another commonly used term is “trace of blood in urine”.  This is a very non-specific term that can refer to a variety of things.  It may refer to the finding of red blood cells in urine under a microscope; it can also mean that a ‘dipstick test’ detects the possible presence of blood.  When dipstick shows ‘blood” it is possible that you may not have any blood in your urine and that dipstick is a false alarm.

What are the Causes of Blood in Urine?

There are many causes of bloody urine.  These include urine infection (UTI) or kidney infection (pyelonephritis), kidney dysfunction, kidney stones, bladder cancer, kidney cancer.  In men, enlarged prostate (BPH) and prostate cancer can cause blood in urine.  In women, cervical and uterine cancer can cause blood to appear in the urine.  Occasionally, colon cancer can cause urinary tract bleeding.

What Do You Need to Do If You Have Blood in Urine?

If you see blood in urine, you need to schedule an appointment to see a board certified urologist.   Dr. Alex Shteynshlyuger is a board-certified urologist who specializes in the treatment of blood in urine in New York City.  Many but not all patients require a procedure called cystoscopy to look inside the bladder, a CT scan and urine testing.  Additional testing may be necessary depending on doctor’s evaluation.

How is Microscopic Hematuria Diagnosed?

There are 2 tests that are used for diagnosis of microscopic hematuria, (1) dipstick urinalysis and (2) microscopic urinalysis.

It is important to carefully examine the results of urinalysis test to see if it was performed by dipstick or using microscopic evaluation.

Dipstick test is a screening test and if positive for blood requires confirmation with microscopic urinalysis

In general, more than 3-5 red blood cells per high power field on microscopic urinalysis is concerning, especially in people over age 40 and those with risk factors.  The more red blood cells are visible under the microscope, the higher the chance that there is a significant problem in the urinary tract causing blood to appear in the urine.

Microscopic hematuria is also referred to as:

  • presence of occult blood in urine
  • microscopic blood in urine
  • microscopic hematuria
  • RBC (red blood cells) in urine.

A positive dipstick test for blood in urine should NOT be called ‘microscopic hematuria’ unless the test is confirmed using microscopic examination.

As a general rule, gross or visible blood in the urine always requires a thorough urological evaluation.  Care and treatment for hematuria depend on the cause of bleeding.

Microscopic hematuria is more common and can be a sign of significant disease or a minor nuisance with no long-term health consequences. However recent studies show that people with microscopic hematuria without an identified cause are at higher long-term risk for renal insufficiency.  It is probably prudent to have a thorough preventive evaluation and management for anyone with persistent microscopic hematuria even if a cause is not identified.  Typically the primary care physician would refer patients with hematuria to a urologist for a full evaluation.

Where Does Blood in Urine Come From?

Anatomically, red blood cells in urine can originate from the kidneys, ureters, bladder, urethra and in men, prostate as well.  Sometimes, blood in the urine can be a sign of a problem in another part of the body that is affecting the urinary tract. For example, colon cancer and cervical can sometimes cause blood in urine. Severe sepsis, blood infection, can cause blood in urine through injury of the kidneys.

In the following article, we discuss the common causes of blood in urine or hematuria in men and women. Some causes of blood in urine in men are different than the causes of hematuria in women.

Schedule an Appointment with Dr. Shteynshlyuger:

Call today: (646) 663-5515 or make an appointment online

Dr. Alex Shteynshlyuger is a fellowship trained board-certified urologist with expertise in evaluation and treatment of blood in urine in men and women using modern effective and proven treatment methods.  He is highly recommended by top primary care physicians in the New York area. If you or someone you know has been experiencing urological symptoms, make an appointment to take advantage of Dr. Shteynshlyuger’s expert advice. Please feel free to Contact Us with any questions.


If you have any questions, to schedule a consultation or if you need a second opinion, please contact us or call  1 (646) 663-5515

We see patients from all parts of New York City (Manhattan, Brooklyn, Queens, Bronx, Staten Island), Long Island, Westchester and New Jersey as well as other parts of the USA. We also see international patients from Canada, Japan, South America, Russia, Asia, Europe, Middle East, Africa, the Caribbean and other parts of the world.

Dr. Alex Shteynshlyuger is a board-certified urologist. He specializes in evaluating women and men with blood in urine. We also offer second and third opinion services for hematuria (blood in urine) and bladder cancer.  We care for men and women of all ages in NYC as well as visitors both from neighboring states and international patients.


This post is also available in: Russian

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