The following tests and exams play a key role in finding a cause for blood in your urine:
- Physical exam, which includes a discussion of your medical history.
- Urine tests. Even if your bleeding was discovered through urine testing (urinalysis), you're likely to have another test to see if your urine still contains red blood cells. A urinalysis can also check for a 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 CT or MRI scan or an ultrasound exam.
- Cystoscopy. Your doctor threads a narrow tube fitted with a tiny camera into your bladder to examine the bladder and urethra for signs of disease.
Sometimes, the cause of urinary bleeding can't be found. In that case, your doctor might 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.
Depending on the condition causing your hematuria, treatment might involve taking antibiotics to clear a urinary tract infection, trying a prescription medication to shrink an enlarged prostate or having shock wave therapy to break up bladder or kidney stones. In some cases, no treatment is necessary.
Be sure to follow up with your doctor after treatment to ensure there's no more blood in your urine.
Preparing for your appointment
You're likely to start by seeing your family doctor or primary care provider. Or you might be referred to a doctor who specializes in urinary tract disorders (urologist).
Here's some information to help you prepare for your appointment.
What you can do
Make a list of:
- Your symptoms, including any that may seem unrelated to the reason for which you scheduled the appointment, and when they began
- Key medical information, including other conditions for which you're being treated, and whether bladder or kidney diseases run in your family
- All medications, vitamins or other supplements you take, including doses
- Questions to ask your doctor
For hematuria, some questions to ask include:
- What are the possible causes of my symptoms?
- What tests do I need?
- Is my condition likely temporary?
- What treatments are available?
- I have other health issues. How can I best manage them together?
- Are there brochures or other printed material that I can have? What websites do you recommend?
Don't hesitate to ask other questions.
What to expect from your doctor
Your doctor is likely to ask you questions, such as:
- Do you have pain when you urinate?
- Do you see blood in your urine only sometimes or all the time?
- When do you see blood in your urine — when you start urinating, toward the end of your urine stream or the entire time you're urinating?
- Are you also passing blood clots during urination? What size and shape are they?
- Do you smoke?
- Are you exposed to chemicals on the job? What kinds?
- Have you had radiation therapy?