Blood in the urine is often the first sign that something in the urinary system needs attention. Sometimes the cause is straightforward and easily treated; other times, it calls for a closer look. Either way, recognizing hematuria and understanding what comes next is the first step toward clear answers and appropriate care.
In many cases, evaluation begins with a primary care provider, who can assess symptoms, order initial urine testing, and determine whether further evaluation is needed.
Understanding Hematuria (Blood in the Urine)
Blood in the urine can appear in different ways. Some people notice a visible color change — such as pink, red, or tea-colored urine — while others have no outward signs at all and learn about it through routine lab testing. Both situations are important to discuss with a healthcare provider.
There are two main types of hematuria:
Gross hematuria
This refers to blood that is visible to the naked eye. Urine may appear pink, red, or brown due to the presence of red blood cells. In some cases, small clots may be seen as well.
Microscopic hematuria
With microscopic hematuria, urine looks normal, but red blood cells are detected during a urinalysis. This is often identified during annual checkups or routine testing. Depending on your age, symptoms, and health history, further evaluation may be recommended.
Whether blood is visible or only detected under a microscope, sharing details with your provider — such as timing, frequency, and whether symptoms like pain or burning are present — helps guide next steps. Importantly, hematuria can occur without pain or other symptoms, and even painless blood in the urine should be medically evaluated to ensure nothing significant is overlooked.
Common Causes of Blood in the Urine
Hematuria can occur for a variety of reasons, ranging from temporary and benign to more complex medical conditions. Common causes include:
- Urinary tract infections (UTIs), which are common and often treatable with medication
- Kidney stones, which can irritate the urinary tract as they move
- Kidney infections or kidney disease
- An enlarged prostate, particularly in aging men
- Certain medications, including blood thinners
- Strenuous or prolonged exercise
- Injury or trauma to the kidneys or urinary tract
Less commonly, blood in the urine may be associated with cancers of the bladder, kidney, or prostate. While this is not the most common cause, early evaluation plays an important role, as conditions like bladder cancer are often more treatable when identified early.
When to See a Urologist for Hematuria
If blood in the urine is detected, your primary care provider will often begin the evaluation by ordering a urinalysis and reviewing your symptoms and medical history. Based on those findings, your provider may recommend additional testing or refer you to a urologist for further assessment.
A urologist specializes in the urinary system and can help determine the underlying cause of hematuria through more detailed evaluation. A urologist may recommend diagnostic steps such as imaging studies — including ultrasound or CT scan — urine testing, or other evaluations tailored to your individual situation.
Referral to a urologist is especially important when hematuria is unexplained, recurrent, or associated with risk factors such as age, smoking history, or prior urinary conditions. For certain conditions, including bladder cancer, earlier detection can lead to more treatment options and better outcomes.
What to Expect During a Urology Evaluation
During a urology visit, your provider will review your medical history, symptoms, and any prior test results. Additional testing may be recommended to better understand the source of the bleeding and rule out potential concerns. The goal is to provide clear answers and, when needed, create a treatment or monitoring plan that fits your needs.
Even if blood in the urine occurs only once or without discomfort, evaluation often brings reassurance — and when treatment is needed, timely care supports better long-term outcomes.
Blood in the Urine: Taking the Next Step
If you’ve noticed blood in your urine or have been advised to follow up after a urine test, the team at board-certified urologists in urology clinics is here to help. We focus on thoughtful evaluation, clear communication, and personalized care — so you can move forward with confidence and understanding. Contact us today to schedule an appointment and learn more about your next steps.