What Blood in Your Urine Could Mean

Seeing blood in your urine can be alarming — but understanding the possible causes and knowing what steps to take can help you stay informed and in control.

If you detect blood in your urine, it’s important not to panic. Still, you should never ignore it — even if it happens only once or seems to go away on its own. There are many possible reasons for blood to appear in the urine, and while it doesn’t always point to a serious condition, it’s important to have it evaluated by a urologist.

The medical term for blood in urine is hematuria. It can be invisible to the naked eye (microscopic hematuria) or appear as pink, red or brown discoloration (macroscopic or visible hematuria). “If you notice bright or dark red urine, call your doctor immediately so they can help determine the case,” says Jullet Han, MD, a urologic oncologist with USC Urology, part of Keck Medicine of USC.

What causes the blood in your urine?

The first step is to make sure what you’re seeing is actually blood. Sometimes, urine can appear discolored after consuming foods with strong pigments — like beets, blackberries or rhubarb — or certain food dyes. Some medicines such as aspirin, blood thinners, antibiotics (nitrofurantoin, penicillin or rifampicin) and over-the-counter medications containing phenazopyridine may cause urine to look red, orange or brown. Additionally, dark urine may simply be a sign of dehydration.

When blood is present, it typically comes from somewhere along the urinary tract — the kidneys, ureters, bladder, prostate (men) or urethra. Causes can range from simple infections to more serious conditions. Physicians tailor the evaluation to each individual based on symptoms and risk factors. “If someone comes to me with blood in their urine as well as pain, the first thing I want to rule out is a urinary tract infection,” Dr. Han says. “Visible blood without any pain is more worrisome and warrants prompt evaluation.”

Common causes of blood in urine

There are many conditions that may cause blood in urine. Common ones include:

• Enlarged prostate gland, also known as benign prostatic hyperplasia (BPH): A common condition in older men where the prostate grows larger, potentially causing urinary symptoms, including difficulty with starting the urinary stream or incomplete emptying the bladder.
• Kidney stones: Hard deposits of minerals and salts that can form in the kidneys, sometimes causing severe pain if they move through the urinary tract.
• Kidney infection: A serious condition that can cause high fevers and pain in the lower back or side.
• Urinary tract infection: A condition which typically causes pain and burning during urination.
• Urethritis: Inflammation of the urethra often resulting from a sexually transmitted infection, which may cause burning during urination and discharge.

More serious conditions that can cause blood in urine

Dr. Han emphasizes that some serious conditions may not present with physical symptoms until they are more advanced. That’s why any presence of blood in the urine — whether visible or microscopic — should never be ignored and warrants medical evaluation. Potential underlying causes include:

• Bladder cancer
• Ureteral cancer
• Kidney cancer
• Prostate cancer
• Urethral cancer

What happens at the specialist’s office visit

The way we evaluate blood in the urine has changed considerably in recent years, Dr. Han explains. “Previously, any patient presenting with microscopic hematuria would routinely undergo a CT scan with contrast and cystoscopy — a procedure used to examine the inside of the bladder. Today, we use a risk-based approach that considers factors such as age, sex, the number of red blood cells and risk factors to guide imaging and/or further testing.” This risk-stratified approach allows for more personalized, thoughtful care — minimizing unnecessary imaging and procedures while ensuring high-risk cases are thoroughly evaluated.

What is the treatment for blood in urine?

In most cases, the evaluation for blood in the urine does not reveal a serious cause. However, Dr. Han emphasizes the importance of continuing annual physical exams and lab tests with your primary care physician.

If a source within the genitourinary tract is identified, such as a stone or mass, patients will receive a personalized treatment plan tailored to their specific condition and needs.

Being proactive matters

Finding blood in your urine can be unsettling but understanding how to respond is essential. Keep these key points in mind:

1. Don’t panic — but don’t ignore it. Even if it happens only once or seems to go away, it should always be evaluated.
2. Blood in the urine is never normal. It’s a sign that something needs further investigation.
3. Always request a urine test if you have urinary symptoms. Don’t accept antibiotics without proper testing.
4. Make annual check-ups and urinalysis part of your routine care. Early detection matters.
5. Be proactive. Notice changes in your urinary health and don’t hesitate to speak up.

“The risk is never zero,” says Dr. Han. “There shouldn’t be blood in the urine.”

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