Welcome to our Guide for men who have noticed blood in their urine.

The medical term for blood in the urine is hematuria. Urine that contains blood can appear pink, red, maroon, or even have a dark smoky color that looks like cola. You may or may not see blood clots, which can look like coffee grounds. Rarely, red urine may be caused by certain foods or medicine. Your doctor will want to test a sample of your urine to confirm that its red color is caused by blood.

Urinary tract infections, kidney stones and prostate problems are common reasons for this symptom. Less commonly, blood in the urine can indicate a more serious condition.

All men who experience blood in the urine as a new problem should see their doctor. Even if you've had blood in the urine in the past, contact your doctor again.

This guide is intended to provide helpful information while you are awaiting further evaluation, or add to what you may have already learned after your visit with a doctor. Please keep in mind that this information cannot replace a face-to-face evaluation with your own health care provider.

Let's get started

Blood in the urine can be quite alarming, but keep in mind that it's unusual for men to bleed large amounts through the urine. Even a small drop of blood can turn an entire toilet bowl of water bright red.

However, large blood clots can be dangerous because they can block the flow of urine. They can also cause a fair amount of discomfort as they pass out of the bladder. In general, any blood clot that's bigger than the tip of your little finger would be considered to be large.

Have you passed one or more large clots in the urine?

Yes, I've passed one or more large clots.

No, I'm passing only small clots or my urine is just red.

Large blood clots can signal a medical emergency. So can blood in the urine that's accompanied by pain in the back, sides, lower abdomen or groin. This type of pain may be caused by

• kidney stones

• injury to the kidneys or bladder

• urinary tract infections

• tumors of the kidney, prostate or bladder.

Has the blood in your urine occurred around the same time as pain in your back, sides, belly or groin?

Yes, I have had pain in my back, sides, belly or groin.

No, I have not had pain.

Serious urinary tract infections usually cause pain. However, sometimes the only symptoms are blood in the urine along with

• fevers

• chills

• nausea or vomiting

• rash.

Have you noticed any of these symptoms?

Yes, I have one or more of these symptoms.

No, I have not any of these symptoms.

So far, you've indicated that you have blood in your urine, but that you've passed no large blood clots, have no pain, and have no fevers, chills or nausea.

Sometimes blood in the urine can indicate a problem with the urethra, the tube that carries urine out from the bladder out through the penis. Other symptoms that can indicate a problem with the urethra include burning with urination, or a discharge from the tip of the penis.

Have you noticed burning with urination, or a discharge from the tip of the penis?

Yes, I've noticed burning or a discharge.

No, I've not had any of these symptoms.

The next few questions will ask about symptoms that might indicate a serious medical problem is causing the blood in you urine. For example, blood in the urine can be a sign of prostate cancer, kidney cancer or bladder cancer. Other symptoms of these cancers include

• unintentional weight loss

• severe pain in the spine or other bones

• unusual fatigue.

Have you noticed weight loss, severe bony pain, or unusual fatigue?

Yes, I've noticed one or more of these symptoms.

No, I've not noticed any of these symptoms.

Blood in the urine can be a sign of kidney disease. Other signs of kidney disease include

• swelling of the ankles, hands or face

• sudden bloating or weight gain

• new high blood pressure

• unusual headaches.

Have you noticed any of these symptoms?

Yes, I've noticed one or more of these symptoms.

No, I've not noticed any of these symptoms

Bleeding from the bladder often occurs after radiation therapy to the pelvis -- a condition called radiation cystitis. Radiation may be given in this area for cancer of the prostate, bladder, and bowel, and certain other types of cancer. Bleeding form radiation cystitis can start months or even years after radiation treatment has been completed.

Have you ever had radiation therapy to the pelvis?

Yes, I have radiation therapy in the past.

No, I've never had radiation therapy

Blood in the urine can also be a sign of prostate problems, such as enlargement of the prostate or a chronic prostate infection. Other symptoms of prostate problems include

• loss of urine control

• difficulty passing urine

• frequent urination.

Have you had any problems with loss of urine control, difficulty passing your urine, or a need to urinate frequently?

Yes, I've recently noticed one or more of these symptoms.

No, I've not noticed any of these symptoms

Sometimes the urine can be turned red from something other than blood, such as

• red foods such beets

• food that contains large amounts of red food coloring

• certain drugs, such as phenazopyridine (Pyridium).

Have you recently eaten beets or another type of red food or taken a drug like phenazopyridine?

Yes, now that you mention it, I did!

No, I have not.

Based on your answers, it's difficult to identify a single likely cause of the blood in your urine. In many people, small amounts of blood are harmless, and no specific cause may be found even after an extensive evaluation.

Still, it's important that you contact your doctor; until you have an evaluation it's impossible to know whether the blood in your urine might signal an important medical condition.

Your doctor will usually start by performing a physical examination and analyzing a urine specimen. If no cause for the bleeding is apparent, your doctor may refer you to a specialist (such as a urologist or nephrologist), or order additional tests such as

• a computed tomography (CT) scan of the abdomen

• an ultrasound of the kidneys

• an older type of x-ray known as an intravenous pyelogram (IVP)

• a cystoscopy, which uses a thin flexible telescope to look at the lining of the bladder.

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The red color in your urine may be harmless. If the red color persists for more than 24 hours, you should still have you urine tested by your doctor to make sure that no blood is present.

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Contact your doctor. You should have a medical evaluation to determine the cause of the blood in your urine. If your doctor suspects a prostate problem, he or she may recommend medication. You may need a procedure called cystoscopy to look at the lining of the prostate and bladder.

You've completed this Decision Guide - we hope it was helpful!

Contact your doctor. You should have a medical evaluation to determine the cause of the blood in your urine. If your doctor suspects radiation cystitis, you may need a procedure called cystoscopy to look at the lining of the bladder.

You've completed this Decision Guide - we hope it was helpful!

Contact your doctor. You should have a medical evaluation to investigate the blood in your urine, as well as the other symptoms. Your doctor will want to examine your urine, and may order blood tests or an ultrasound scan of your kidneys.

You've completed this Decision Guide - we hope it was helpful!

Contact your doctor. You should have a medical evaluation to investigate the blood in your urine, as well as the other symptoms. Your doctor will want to examine your urine, and may order blood tests or special x-rays.

You've completed this Decision Guide - we hope it was helpful!

Contact your doctor. You should have a medical evaluation. You may have a condition called urethritis, which is an infection or inflammation of the urethra. Most cases of urethritis are caused by sexually transmitted infections such as gonorrhea and chlamydia.

Burning with urination can also be caused by bladder infections, and by infection or inflammation of the prostate.

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Contact your doctor immediately! You may have a serious urinary tract infection, or other serious medical problem that is causing the blood in your urine. You should have an urgent medical evaluation.

Once you've received attention, return to this Decision Guide.

The most common reasons to have pain and blood in the urine are kidney stones and urinary tract infections. However, some injuries can cause the same symptoms.

Have you recently had a serious injury to the back or side, such as motor vehicle accident, fall, assault, or industrial accident?

Yes, I have had a recent injury to my back or side.

No, I haven't had a recent injury.

Good!

Have you ever had kidney stones in the past?

Yes, I've had one or more kidney stones before.

No, I've never had kidney stones before.

Men who develop one kidney stone are prone to developing more. The most likely cause for your symptoms is another kidney stone that has gotten stuck on its way out of the body.

Keep in mind that the blood in your urine deserves a medical evaluation, even if your symptoms go away without treatment, so see your doctor.

Symptoms of kidney stones that usually require urgent evaluation include:

• Severe pain, that's not controllable with non-prescription drugs

• Nausea or vomiting, especially if you are unable to eat or drink

• Fever over 100.5 degrees F.

Have you had one or more of these symptoms?

Yes, I've had one or more symptoms.

No, I've not had any of these symptoms.

Good.

You may be able to manage your symptoms at home for now. Unless you've been told to avoid non-prescription pain relievers, you can try acetaminophen (Tylenol), ibuprofen (Advil) or naproxen (Aleve) for your pain. You should force fluids to try to flush out the stone -- this really works.

You should contact your doctor if

• You need a stronger pain reliever.

• You are experiencing nausea that makes it hard to keep down fluids.

• You develop a temperature over 100.5 degrees F.

• Your pain continues for more than 48 to 72 hours.

If your symptoms improve, you may not need immediate evaluation by your doctor. You may see a tiny dark stone as it passes out of your body into the toilet. (If so, fish it out -- your doctor may want to send it to the laboratory for analysis). However, keep in mind that you will eventually need to see your doctor to make sure that no microscopic traces of blood remain in the urine, and that no other stones can be found in the kidneys.

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Contact your doctor immediately! You may have a urinary tract infection in addition to a kidney stone, or a severely blocked kidney stone that requires removal or other type of treatment. You may also benefit from prescription antibiotics or pain medications, or intravenous (IV) fluids to prevent dehydration.

Once you've received attention, return to this Decision Guide.

Okay -- from your answers, it's impossible to identify a single most likely cause of blood in your urine, so it is important that you contact your doctor. You need a medical evaluation to make sure your pain and the blood in your urine are not a sign of serious medical problem.

Common causes of your symptoms include

• kidney stones

• urinary tract infections

• tumors of the kidney, prostate or bladder.

You doctor will usually want to start by performing an examination and analyzing a urine specimen. If no cause for the bleeding is apparent, your doctor may refer you to a specialist, or order additional tests such as

• a computed tomography (CT) scan of the abdomen

• an ultrasound of the kidneys

• an older type of x-ray known as an intravenous pyelogram (IVP)

• a cystoscopy, which uses a thin flexible telescope to look at the lining of the bladder.

You've completed this Decision Guide - we hope it was helpful!

Okay, that's fine.

Remember, if think you may have blood in your urine, see your doctor for evaluation. There are a number of causes - although many are not dangerous, blood in the urine may be due to a serious condition.

Great! Here is a list of the most common reasons a man may have blood in the urine.

• Bladder tumor

• Kidney tumor

• Kidney stones

• Prostate inflammation

• Prostate tumor

• Prostate enlargement

• Sexually transmitted diseases, including chlamydia and gonorrhea

• Urethritis

• Urinary tract infections

Common tests to evaluate blood in the urine, other than routine blood and urine tests, include

• Computed tomography (CT)

• Cystoscopy

• Ultrasound

Contact your doctor immediately! Pain in the back or sides with blood in the urine after an injury can signal serious damage to the kidneys. You may need emergency medical treatment.

Once you've received attention, return to this Decision Guide.

Contact your doctor immediately! Large blood clots can block the bladder or kidney. You may need a catheter inserted into the bladder to prevent such a blockage.

Once you've received attention, return to this Decision Guide.