Tests and diagnosisBy Mayo Clinic Staff
To find a cause for urinary bleeding, the following tests and exams play a key role:
- Physical exam, which includes a discussion of your medical history.
- Urine tests. Even if your bleeding was first discovered through urine testing (urinalysis), you're likely to have another test to see if your urine still contains red blood cells. Urinalysis can also check for urinary tract infection or the presence of minerals that cause kidney stones.
- Imaging tests. Often, an imaging test is required to find the cause of hematuria. Your doctor might recommend a computerized tomography (CT) scan, which uses radiation and a powerful computer to create cross-sectional images of the inside of the body; magnetic resonance imaging (MRI), which uses a magnetic field and radio waves instead of X-rays to produce images; or an ultrasound exam. Ultrasound uses a combination of high-frequency sound waves and computer processing to produce images of your kidneys and bladder.
- Cystoscopy. In this procedure, your doctor threads a narrow tube fitted with a tiny camera into your bladder to closely examine both the bladder and urethra for signs of disease.
Sometimes, the cause of urinary bleeding may not be found. In that case, your doctor may recommend regular follow-up tests, especially if you have risk factors for bladder cancer, such as smoking, exposure to environmental toxins or a history of radiation therapy.
Aug. 29, 2014
- Wein AJ, et al. Campbell-Walsh Urology. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.clinicalkey.com. Accessed July 7, 2014.
- Feldman AS, et al. Etiology and evaluation of hematuria in adults. http://www.uptodate.com/home. Accessed July 7, 2014.
- Davis R, et al. Diagnosis, evaluation and follow-up of asymptomatic microhematuria (AMH) in adults: AUA guideline. Journal of Urology. 2012;188:2473.
- Sharp VJ, et al. Assessment of asymptomatic microscopic hematuria in adults. American Family Physician. 2013;88:747.
- Adams JG, et al. Emergency Medicine: Clinical Essentials. 2nd ed. Philadelphia, Pa.: Saunders Elsevier; 2013. http://www.clinicalkey.com. Accessed July 7, 2014.
- AskMayoExpert. What are common causes of gross hematuria? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2014.
- Mercieri A. Exercise-induced hematuria. http://www.uptodate.com/home. Accessed July 7, 2014.
- Urinary tract infections: What you need to know. National Kidney and Urologic Diseases Information Clearinghouse. http://kidney.niddk.nih.gov/KUDiseases/pubs/uti_ES/index.aspx. Accessed July 7, 2014.
- Hematuria: Blood in the urine. National Kidney and Urologic Diseases Information Clearinghouse. http://kidney.niddk.nih.gov/KUDiseases/pubs/hematuria/. Accessed July 7, 2014.
- King K, et al. Haematuria: From identification to treatment. British Journal of Nursing. 2014;23:S28.
- Marx JA, et al. Rosen's Emergency Medicine. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2014. http://www.clinicalkey.com. Accessed July 7, 2014.
- AskMayoExpert. What tests are needed to confirm the diagnosis or expedite the evaluation of gross hematuria? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2014.
- Castle EP (expert opinion). Mayo Clinic, Scottsdale/Phoenix, Ariz. July 21, 2014.