Seeing red or pink urine can be worrying. It may happen because of a urinary infection or kidney stone, but it can also be linked to problems with the kidneys, bladder, prostate, or urinary tract that need medical attention.
Blood in urine is medically called haematuria. It can be visible to the naked eye or detected only through a urine test. Knowing the possible causes and when to seek medical care can help you take the right steps without unnecessary worry.
What Does Blood in Urine Mean?
Haematuria means that red blood cells are present in the urine. There are two main types:
- Visible haematuria: The urine may appear pink, red, or brown.
- Microscopic haematuria: The urine looks normal, but red blood cells are detected during urine testing.
Even a small amount of blood can change urine colour. The amount of blood does not always indicate how serious the underlying cause is.
What Causes Blood in Urine?
There are several possible causes. Some are common and easily treated, while others require a detailed medical evaluation.
1. Urinary tract infection: A urinary tract infection (UTI) can cause blood in the urine, particularly when the bladder or urethra becomes inflamed.
Common urinary infection symptoms include:
- Burning or pain while urinating
- Frequent urge to urinate
- Passing small amounts of urine
- Lower abdominal discomfort
- Cloudy or strong-smelling urine
- Sometimes, blood in the urine
If the infection reaches the kidneys, you may have fever, chills, nausea, vomiting, and pain in the back or side.
2. Kidney or urinary stones: Kidney stones can irritate the urinary tract and cause bleeding. They may also cause sudden, severe pain in the side, back, lower abdomen, or groin. Some people also experience pain while urinating, nausea, vomiting, or an increased urge to urinate.
3. Prostate problems: In men, an enlarged prostate, also called benign prostatic hyperplasia (BPH), may sometimes cause blood in the urine. Prostate infections and, less commonly, prostate cancer can also be associated with haematuria.
4. Kidney disease: Certain kidney conditions can cause blood cells to leak into the urine. This may occur along with other findings such as protein in the urine, swelling, high blood pressure, or changes in kidney function.
5. Injury or recent procedures: An injury involving the urinary tract or certain medical procedures can temporarily cause bleeding. Strenuous exercise can also occasionally cause haematuria.
6. Medicines and bleeding disorders: Certain medicines, including blood thinners, can contribute to bleeding. However, blood-thinning medication should not be stopped on your own if you notice blood in your urine. Speak to your doctor about the symptom and your medicines.
7. Cancer of the urinary tract: Although there are many non-cancerous causes, blood in the urine can sometimes be an early sign of bladder, kidney, or prostate cancer.
For this reason, unexplained or recurring bleeding should be evaluated, particularly in people with risk factors such as increasing age or a history of smoking.
Blood in Urine With or Without Pain: Does It Matter?
Not necessarily.
A common misconception is that a serious problem must cause pain. However, visible haematuria can occur without pain or other symptoms. Microscopic haematuria may also have no noticeable symptoms at all.
For example, burning while urinating with blood may suggest a UTI, while severe pain in the side or groin may point towards a stone. Painless visible bleeding may need a more detailed evaluation.
The key point is that the absence of pain does not automatically mean the symptom is harmless.
When Is Blood in Urine Serious?
You should seek medical evaluation if you notice blood in your urine, particularly if it is visible or keeps returning. Seek urgent medical attention if it is accompanied by:
- Severe pain in the side, back, or abdomen
- Fever or chills
- Vomiting
- Difficulty or inability to pass urine
- Large blood clots in the urine
- Significant weakness, dizziness, or fainting
- Swelling with reduced urine output
How Is Blood in Urine Diagnosed?
The first step is usually a detailed medical history, physical examination, and urine testing. Depending on the findings, your doctor may recommend:
Urine tests: A urinalysis can detect blood and may also provide clues about infection, protein in the urine, or other abnormalities. A urine culture may be recommended when a UTI is suspected.
Blood tests: Blood tests can help assess kidney function and look for other conditions that may be contributing to the bleeding.
Ultrasound or CT scan: Imaging can help identify kidney stones, blockages, masses, or other urinary tract abnormalities. The most appropriate scan depends on your symptoms and individual risk factors.
Cystoscopy: A cystoscopy allows a urologist Gurgaon to examine the inside of the bladder and urethra using a thin camera. It may be recommended when further evaluation of the lower urinary tract is needed. The 2025 AUA/SUFU guideline recommends a risk-based approach to evaluating microscopic haematuria. Factors such as age, smoking history, the degree and persistence of haematuria, and other risk factors are considered.
What Should You Do If You Notice Blood in Your Urine?
A few practical steps can help:
- Contact a doctor, particularly if the bleeding is visible or unexplained.
- Note any accompanying symptoms, such as burning, fever, pain, or changes in urination.
- Mention your medicines, especially blood thinners.
- Tell your doctor about recent exercise, injuries, procedures, or infections.
- Follow up on abnormal urine tests, even if you feel completely well.
In women, menstrual blood can sometimes contaminate a urine sample. If this is suspected, your doctor may recommend repeating the test after menstruation has ended.
How Can PB Health Support You?
If you notice blood in your urine, a doctor can review your symptoms, medical history, urine and blood test results, and imaging reports to identify the likely cause and guide you to the appropriate specialist. At PB Health Hospital, IFFCO Chowk, Gurgaon, the right specialist can help with further evaluation and treatment, if needed.
Conclusion
Blood in urine can have several causes, from urinary infections and kidney stones to conditions affecting the kidneys, bladder, or prostate. While many causes are treatable, unexplained or recurring bleeding should be evaluated by a doctor. Early assessment can help identify the cause and guide appropriate treatment.
The key takeaway: If you see blood in your urine, even once, speak with a healthcare professional rather than assuming it will go away on its own.