Clots in the Urine | Hematuria | Causes | Symptoms | Diagnosis | Treatment
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Clots in the Urine ( Hematuria ) - Causes, Symptoms, Diagnosis, and Treatment

Published on Sep 20, 2021 and last reviewed on Mar 06, 2023   -  5 min read


The typical color of urine ranges from pale yellow to deep amber but peeing blood clots or having red-colored urine signals some severe health problems. Please read the article to know about the causes, diagnosis, and treatment for blood clots in urine.

Clots in the Urine ( Hematuria ) - Causes, Symptoms, Diagnosis, and Treatment

What Is Hematuria?

Hematuria is a condition characterized by the presence of excessive blood in the urine. There are two types of hematuria, they are,

  • Microscopic Hematuria - When the blood in the urine is not visible to the naked eye, and can be detected only through laboratory examination, it is known as microscopic hematuria.

  • Macroscopic Hematuria - When the blood in the urine is visible to the naked eye, it is called macroscopic hematuria.

What Are the Symptoms of Hematuria?

Gross hematuria produces red or pink-colored urine due to the presence of red blood cells (RBC). A little blood is enough to make the urine red, and bleeding is usually not painful, but passing blood clots in the urine can be painful. In some instances, the presence of blood in the urine will not produce any symptoms.

What Are the Causes of Hematuria?

Hematuria is a condition in which the kidneys or other parts of the urinary tract allow red blood cells to leak into urine. Some other problems that can cause this leakage are,

1. Urinary Tract Infections (UTI) - UTI occurs when bacteria enter the body through the urethra and multiply in the bladder.


  • Persistent urge to urinate.

  • Pain during urination.

  • Burning sensation with urination.

  • Offensive odor in urine.

2. Enlarged Prostate - The prostate gland, which is just below the bladder and surrounding the top part of the urethra, is often enlarged in middle-aged men. It then compresses the urethra and partially blocks the urine flow.


  • Difficulty in urinating.

  • Urgent or persistent need to urinate.

  • Visible or microscopic blood in the urine.

3. Kidney Infections (Pyelonephritis) - Pyelonephritis occurs when bacteria enter the kidneys from the bloodstream or move from the ureters to the kidneys.


4. Bladder or Kidney Stone - The minerals present in the concentrated urine sometimes form crystals on the kidney or bladder walls. After some time, these crystals become small and turn into hard stones.


It is painless and does not produce pain until it causes blockage or is being passed. After it starts to block the urine it creates,

  • Excruciating pain.

  • Visible or microscopic blood in the urine.

  • Fever.

  • Vomiting.

  • Chills.

  • Nausea.

5. Inherited Disorders - Sickle cell anemia is a hereditary disorder of hemoglobin in red blood cells (RBC), which causes blood in the urine (both visible and microscopic hematuria).

6. Cancer - Visible blood in the urine may be a sign of advanced bladder, kidney, or prostate cancer.

7. Medications - Urinary bleeding can be caused by anti-cancer drugs such as,

  • Cyclophosphamide.

  • Penicillin.

Visible urinary bleeding sometimes occurs on taking an anticoagulant, such as,

  • Aspirin.

  • Blood thinner heparin.

8. Kidney Injury - A blow or other injuries in the kidneys from contact sports or an accident can cause visible blood in the urine.

9. Strenuous Exercise - It is rare for strenuous exercises to cause gross hematuria, but the cause is unknown. It is linked to,

  • Trauma to the bladder.

  • Dehydration.

  • Breakdown of red blood cells.

Runners are most commonly affected, and anyone can develop visible urinary bleeding after intense workouts.

Other reasons for having blood in the urine are,

  1. Trauma.

  2. Vigorous exercise.

  3. Hepatitis virus causing inflammation of the liver and liver diseases.

  4. Sexual activity.

  5. Menstruation.

  6. Endometriosis.

More serious causes for people to have hematuria are,

  1. Bladder or kidney cancer.

  2. Inflammation of the urethra, kidney, bladder, or prostate.

  3. Blood-clotting disorders, such as hemophilia.

  4. Sickle cell disease (abnormal shaped red blood cells).

  5. Polycystic kidney disease.

What Are the Risk Factors of Hematuria?

Anyone can have red blood cells in the urine, including children and teens. The following are the risk factors of hematuria,

  1. Men above 50 years of age have occasional hematuria due to an enlarged prostate gland.

  2. The viral or bacterial infection leads to inflammation of the kidneys (post-infectious glomerulonephritis), which can cause visible urinary blood in children.

  3. Family history of kidney stones or disease has increased risk of blood in the urine.

  4. Aspirin, nonsteroidal anti-inflammatory drugs, and antibiotics such as Penicillin increase the risk of urinary bleeding.

  5. Exercise-induced urinary bleeding occurs in long-distance runners, but anyone who does an intense workout can develop these symptoms. The condition is sometimes called jogger's hematuria.

How Is Hematuria Diagnosed?

Hematuria and its cause can be diagnosed with,

  1. Medical history.

  2. Physical examination.

  3. Urinalysis.

  4. Additional testing.

1. Medical History:

Taking a medical history will help a doctor to diagnose the cause of hematuria. It will include,

  • Patient's current and past medical history.

  • Review of symptoms.

  • List of prescription medicines.

  • Over-the-counter medicines.

2. Physical Examination:

During a physical examination, the doctor taps on the abdomen and back to check for pain or tenderness in the kidney or bladder area.

  • Digital rectal examination is done in men to look for any prostate problems.

  • Pelvic examination is done in women to look for red blood cells in the urine.

3. Urinalysis:

The doctor will ask you to test the urine in the office using a dipstick or send it to a laboratory for analysis. Sometimes the urine tests using a dipstick could be positive even though the patient does not have blood in the urine, resulting in a false-positive test. The test samples (urine) are diagnosed under a microscope before ordering other tests.

If you are a woman, before obtaining a urine sample, you will be asked when you last menstruated. Sometimes blood from the menstrual period can get into the urine sample and result in a false-positive test for hematuria. After you stop menstruating, the test will be repeated.

The health care professional will confirm the presence of any red blood cells by examining the collected urine under a microscope before ordering other tests.

4. Additional Testing:

When the urine samples detect too many red blood cells (RBCs), then the doctor will order additional tests. They are,

  • Blood test.

  • Computed tomography (CT) scan.

  • Cystoscopy.

  • Kidney biopsy.

  • Magnetic resonance imaging (MRI).

How Is Hematuria Treated?

Treatment of hematuria involves treating the underlying cause. If it is not caused by a serious condition, then the person typically does not need treatment. Depending on the causative factor of hematuria, treatment includes,Hematuria

  • Antibiotics for urinary tract infections.

  • Prescription medicine to shrink an enlarged prostate.

  • Shock wave therapy to break the bladder or kidney stones.

There is no information about diet and nutrition playing a role in the cause or prevention of hematuria. Make sure to follow up with the doctor after the treatment to determine there is no presence of blood in the urine.

Frequently Asked Questions


Whether Blood Clots in the Urine Serious?

Some causes of hematuria (blood in the urine) can be severe, and others can be harmless and may require no treatment. However, it is necessary to consult a healthcare professional. Gross hematuria often occurs without many symptoms, but heavier bleeding with blood clots is an emergency that can be painful and block bladder outlets leading to urine blockage.


What Cancer Is Associated With Blood in the Urine?

Kidney and bladder cancers are usually associated with blood in the urine. The symptoms will be passing rust-colored urine or clots, tissues, or blood in the urine. Around ten percent of patients with hematuria have kidney or bladder cancer.


Why Do People Experience Hematuria Without Any Infection?

Hematuria can occur without any infections, and it has multiple causes. Sometimes, other red substances (pigments) in the urine, like eating excessive beets, food dyes, or certain medications such as Phenazopyridine, can produce red color in the urine.


What Are the Common Causes of Blood in the Urine?

Hematuria has various causes, including:
 - Urinary tract infections.
 - Bladder or kidney stone.
 - Kidney infections.
 - Enlarged prostate.
 - Kidney, bladder, or prostate cancer.
 - Kidney injuries.
 - Certain medications like Cyclophosphamide and Penicillin.
 - Excess exercise.


Can Dehydration Result in Hematuria?

Severe or continuous dehydration can cause blood in the urine. Lack of water required amount of fluid can exacerbate underlying kidney conditions contributing to kidney disorders like kidney stone, which causes hematuria.


Does Hematuria Go Away on Its Own?

A number of different conditions can cause hematuria. But most of the time, it may not be due to severe causes and will get cured soon. However, treatment might be required, which may involve taking antibiotics or other prescription medication.


Is Hematuria Caused Due to Stress?

Stress is not directly related to blood in the urine. But excessive stress can cause weaker urine retention and incontinence (lack of control over urination); however, it cannot result in hematuria. Hematuria usually occurs due to underlying diseases, such as UTI (urinary tract infection), sickle cell disease, kidney cancer, and others that may cause urinary bleeding.


Which Organ Is Involved in Causing hematuria?

Hematuria usually occurs with kidney or urinary tract diseases, disorders, or injuries. There are various causes for blood in the urine, such as urinary tract infections, kidney stones, kidney or bladder cancer, etc. It is necessary to consult a doctor to rule out the cause and aid in treatment.


What Quantity of Blood Is Considered Hematuria?

When there is the presence of at least five red blood cells/HPF in three of three consecutive centrifuged specimens collected at least seven days apart is considered hematuria. It can be asymptomatic or symptomatic and may have other urinary tract abnormalities.


What Causes Painless Hematuria?

Painless haematuria can usually occur due to underlying malignancies, whereas pain-associated hematuria is commonly seen with UTIs and kidney stones. Also, blood at the start of the urinary stream may be due to lower urinary tract malignancy.


What Is the Prognosis for Blood in the Urine?

The prognosis for hematuria varies depending on the underlying cause. In the case of mild to moderate infection, the prognosis is good. If hematuria is accompanied by proteinuria, it indicates significant kidney disease; in such cases, there is a poor prognosis. Also, hypertension and abnormal renal function have a poor prognosis.


Is Hematuria a Temporary Condition?

Hematuria can last till it eliminates the causative disease or condition. For infections, antibiotics therapy will help to treat the cause and cease hematuria as well. For people with long-term medications such as blood thinners or chronic illnesses, hematuria may last long.


When to Consult a Doctor for Hematuria?

Most cases of blood in the urine are not very serious. Since some of the causes of hematuria are serious, it is necessary to seek medical attention immediately after seeing blood in the urine. Also, immediate medical attention is needed if hematuria is associated with nausea, vomiting, pain in the sides, back, or abdomen, fever, and chills.


Does a Urologist Provide Treatment for Hematuria?

A general physician or urologist provides the treatment for hematuria. Hematuria occurs when blood enters the urine. The urine color will be red, orange, pink, or cola-colored. Urologists use various diagnostic tests to detect hematuria.

Last reviewed at:
06 Mar 2023  -  5 min read




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