Bloody Urine

Question: I am 58 years old and I had bloody urine recently. I felt fine, and now it is clear. I don’t think it is anything to worry about, but my wife thinks I should see my doctor about this. Who is right? Should I be concerned?

Answer: Your wife wins – you should definitely check this out!

Why? Bloody urine (hematuria) never happens without a reason. Even though you are not bleeding today, it doesn’t mean the problem has gone away.

There are many causes of urinary bleeding. Some heal themselves, while others need treatment to prevent serious health problems later.

The most common cause of bleeding is urinary tract infection or irritation. Infection can sometimes be fairly painless, especially if it is low-grade or long-standing. Infection is usually identified by an abnormal urine specimen, or occasionally a bladder scoping (cystoscopy), and is treated with antibiotics.

The next most common cause of bleeding is kidney stones. Only about two-thirds of kidney stones cause pain, and bleeding or infection are the most common signs when pain is absent. Most stones pass on their own or are treated non-surgically if they are large or causing problems.

Third most common, but most serious, is kidney, bladder or prostate cancer. These are among the most common cancers, and they are all highly curable if caught early. Blood in the urine, even if brief or microscopic, can be the earliest sign of one of these cancers being present. Age, smoking and family history are risk factors for these cancers, but they can occur without these risk factors being present.

Finally, abnormal blood vessels (from previous surgery, injury, prostate enlargement or effects of blood thinners) cause most of the remaining cases of bleeding. These can stop on their own, but sometimes need surgery.

Yes, get that bleeding checked out!