Filter Blogs By
Blood in the Urine (Hematuria): Should You Be Worried?
Seeing blood in your urine is alarming. For most people, it’s the kind of symptom that gets dismissed for a day or two — maybe it was something you ate, maybe it will go away on its own — before the anxiety sets in. Sometimes it does resolve without intervention. But hematuria, the medical term for blood in the urine, is one symptom that urologists take seriously regardless of whether it’s painful, how much blood is present, or how briefly it appears. At Lazare Urology, any episode of visible blood in the urine warrants a proper evaluation. Here’s why.
Two Types, One Rule
Hematuria comes in two forms. Gross hematuria is visible to the naked eye — urine that appears pink, red, or the color of cola. Microscopic hematuria is blood detected only through a urine test, invisible without laboratory analysis. Both matter clinically, though gross hematuria tends to prompt faster action because it’s impossible to ignore.
The rule that applies to both is straightforward: a single episode is enough to warrant investigation. Blood in the urine does not need to be persistent or heavy to be significant. Some of the most serious underlying causes — bladder cancer being the clearest example — can produce intermittent bleeding that disappears for weeks before returning.
What Can Cause Hematuria
The list of potential causes is broad, which is part of why a proper workup is necessary before drawing any conclusions.
Kidney stones are one of the most common culprits. As a stone moves through the urinary tract, it can irritate or tear the lining of the ureter, producing blood that may or may not be accompanied by pain. Urinary tract infections can cause hematuria as well, particularly when the infection has reached the bladder. In men, an enlarged prostate can stress the blood vessels around the bladder neck and lead to bleeding.
Strenuous exercise — particularly long-distance running — can occasionally produce what’s called exercise-induced hematuria, a generally benign phenomenon that resolves with rest. Certain medications, including blood thinners like warfarin, increase the risk of bleeding throughout the body, including the urinary tract.
Then there are the causes that demand urgent attention. Bladder cancer, kidney cancer, and other tumors of the urinary tract can all produce hematuria, often without pain, and often intermittently. This is what makes the symptom impossible to dismiss based on how mild it seems. A small amount of blood, appearing once, can be the first and only early sign of a malignancy that is entirely treatable when caught before it progresses.
Why Painless Hematuria Deserves More Urgency, Not Less
There’s a tendency to assume that a symptom without pain is less serious. With hematuria, that instinct can be misleading. Painful hematuria — blood accompanied by a burning sensation or flank pain — often points toward infection or kidney stones, both of which are treatable and typically not cancer. Painless hematuria, particularly in men over 50 or in anyone with a history of smoking, carries a higher index of suspicion for bladder or kidney malignancy.
Smoking is one of the most significant risk factors for bladder cancer, and bladder cancer is the fourth most common cancer in men in the United States. The connection between tobacco exposure and bladder cancer is well established — carcinogens from cigarette smoke are processed by the body and excreted through the urine, where they remain in contact with the bladder lining for extended periods. A man in his 60s who smoked for decades and notices blood in his urine — even once, even briefly — needs a cystoscopy, not a wait-and-see approach.
What a Urological Evaluation Involves
When a patient presents with hematuria at Lazare Urology, the evaluation is methodical. A urinalysis and urine culture rule out infection. Imaging — typically a CT urogram — provides a detailed look at the kidneys, ureters, and bladder for stones, masses, or structural abnormalities. A cystoscopy, in which a thin flexible camera is passed through the urethra into the bladder, allows direct visualization of the bladder wall. It’s performed in the office and takes only a few minutes.
Together, these tests cover the urinary tract comprehensively. Most of the time, a reassuring explanation is found. But when something more serious is present, finding it early makes an enormous difference in treatment options and outcomes.
Don’t Wait for It to Happen Again
The most common mistake people make with hematuria is deciding to monitor it. They see blood once, it goes away, and they tell themselves they’ll go to the doctor if it happens again. Given that bladder and kidney cancers can bleed intermittently, waiting for a second episode means potentially allowing a treatable condition to advance.
At Lazare Urology in Brooklyn, New York, Dr. Lazare evaluates hematuria with the full diagnostic workup it requires. If you’ve noticed blood in your urine — even once, even a small amount — schedule an appointment. It may turn out to be nothing serious. But it’s not a symptom to leave uninvestigated.
Back to Blogs