Seeing your urine turn red is always alarming. The first question that immediately comes to mind is simple: is it serious?
The most accurate answer is this: it is never normal , and it always warrants a medical consultation to find the cause.
There is, of course, one known exception. After eating beets, urine can sometimes take on a reddish tint. Apart from this situation, the presence of blood in the urine, called hematuria , should be taken seriously.
Macroscopic or microscopic hematuria: what's the difference?
Two situations can be distinguished:
- Macroscopic hematuria : blood is visible to the naked eye. The urine is pink, red, or frankly bloody.
- Microscopic hematuria : it is not visible. It is discovered during a urine test carried out for another reason.
In both cases, the source of the bleeding must be identified.
The two main possible causes of blood in the urine
When there is blood in the urine, two main mechanisms are possible.
1. Bleeding from the urinary tract
This is a urological cause. The bleeding can originate from any part of the urinary tract:
- the kidneys ,
- the ureters , which transport urine from the kidneys to the bladder,
- the bladder ,
- the urethra , which carries urine out of the body,
- and even the prostate .
2. A kidney filtration defect
The kidney acts as a filter. It eliminates in the urine what needs to be eliminated and retains in the blood what needs to remain there, particularly red blood cells.
If this filter malfunctions, red blood cells can pass into the urine. The urine then turns red without necessarily indicating a bleeding urological lesion. This type of problem falls more under the purview of a nephrologist.
The main challenge here is to understand the urological causes of hematuria, as these are the ones that most often lead to urgent or rapid consultation.
Common causes of blood in the urine
Urinary tract infection
This is one of the most frequent causes. Generally, the blood is not isolated. It is often accompanied by suggestive symptoms:
- burning sensation when urinating,
- more frequent urges to urinate,
- urgent needs.
The diagnosis is based on a urine culture , that is, a cytobacteriological examination of the urine. Treatment is most often simple, with antibiotic therapy .
Urinary calculus
Another common cause is kidney stones . The kidneys eliminate calcium, notably through urine. Sometimes, this calcium doesn't remain dissolved and clumps together to form a small stone.
This stone can travel from the kidney to the bladder through the ureter. As it moves along, it can irritate the urinary tract and cause bleeding. When it becomes lodged, it causes renal colic , a well-known and often very intense pain.
Hematuria is one of the possible signs of renal colic.
Tumors, benign or malignant
Blood in the urine can also indicate a tumor . It can be benign or malignant, and may affect:
- the kidney,
- the ureter,
- the bladder,
- the urethra,
- or the prostate.
This is precisely why hematuria should never be taken lightly, especially when it occurs without pain or repeatedly.
The timing of the blood's appearance can guide the diagnosis.
In urology, attention is paid to a very useful detail: when the urine turns red . This does not replace examinations, but it can help guide the search for the cause.
Initial hematuria
You start to urinate red, then the urine gradually turns yellow again.
This situation suggests a problem located in the urethra or prostate .
Terminal hematuria
You start urinating normally, then blood appears, especially at the end of urination.
In this case, a bladder problem is more likely.
Total hematuria
Blood is present throughout urination. The urine is red from beginning to end.
This form is less specific. It can be seen in various situations, particularly when bleeding is heavy.
Should we be worried?
Yes, in the sense that you should consult a doctor . No, in the sense that not all causes are serious.
A urinary tract infection is often easily treated. A kidney stone can be identified and treated. However, since hematuria can also indicate a more serious condition, you should never wait for it to resolve on its own without medical advice.
The best course of action is to make an appointment with your general practitioner or directly with a urologist .
What tests can be done?
The assessment depends on the context, associated symptoms and the patient's age, but several tests may be offered.
The urine test
If an infection is suspected, a simple urine test is often the first step. This allows for the detection of bacteria, red blood cells, and other abnormalities.
Urinary tract ultrasound
If it is necessary to check the condition of the kidneys, bladder or to look for an obstruction, an ultrasound of the urinary tract may be indicated.
The urinary scan
When necessary, a CT urogram (a specific scan of the urinary tract) can be performed. This examination is particularly useful for investigating certain causes such as kidney stones or some abnormalities of the urinary tract.
Endoscopy of the urinary tract
In some cases, it is necessary to look directly inside the urinary tract using an endoscopy . This allows for a precise examination of the urethra and bladder.
When should I consult without delay?
As soon as blood is visible in the urine, medical advice should be sought. This is especially important if the hematuria is accompanied by:
- burning during urination,
- significant pain in the back or side,
- very frequent or urgent urges to urinate,
- or if the episode repeats itself.
Even in the absence of pain, the presence of blood in the urine warrants further investigation.
Key takeaways
- Blood in the urine is never normal.
- It could be a urinary tract infection , a kidney stone , a prostate problem, or, sometimes, a tumor .
- The origin may be from the urinary tract or from kidney dysfunction .
- The timing of blood appearing during urination can provide a useful clue.
- An assessment may be based on a urine culture , an ultrasound , a CT urogram or an endoscopy .
The key message is simple: don't ignore hematuria without consulting a doctor . There's no need to panic, but it's essential to get it checked out. In urology, such a visible symptom is precisely an opportunity to quickly diagnose the cause and treat it appropriately.