Urine, bloody or dark

Alternative names:

blood in the urine; hematuria

Definition:

The presence of blood in the urine.

Considerations:

Blood in the urine should never be ignored!

Blood in the urine is usually caused by kidney and urinary tract diseases. However, there are a couple of exceptions:

• In women, the blood may appear to be in the urine when it's actually coming from the vagina.
• In men, the urethra carries both urine and semen out of the body and what may be mistaken for urinary bleeding is sometimes a bloody ejaculation usually due to a prostate problem.

Bladder infections are more common in women than in men and are especially common during pregnancy. Bladder infections are usually accompanied by pain or burning on urination, frequent urgent urination, and occasionally blood in the urine.

Discoloration from drugs or foods can mimic blood in the urine.

Common causes:

• kidney stone
• bladder stones that lodge in the urethra
• tumors of the urinary tract.
• glomerulonephritis
• bladder tumor
• chronic or recurrent urinary tract infection
• cystitis
• pyelonephritis
• urethritis
• enlarged and infected prostate (prostatitis)
• post-streptococcal GN
• urethral ulceration
• hypercalciuria (increased amounts of calcium in the urine)
  • distal renal tubular acidosis
  • use of diuretics ("water pills")
  • hyperparathyroidism
  • hypothyroidism
  • hypercalcemia
  • hypertension
  • juvenile rheumatoid arthritis
  • medullary cystic disease
  • metabolic acidosis
  • neoplasm
  • sarcoidosis

• acute tubular necrosis
• "hardening" of the urinary opening (meatal stenosis)
• trauma
  • fracture of the pelvis
  • renal contusion (bruised kidney)
  • renal fracture ("broken" or torn kidney)
  • urethral trauma

• surgical procedures, including catheterization, circumcision, surgery, and renal biopsy
• drugs
  • anticoagulants
  • cyclophosphamide
  • metyrosine
  • oxyphenbutazone
  • phenylbutazone
  • thiabendazole

Note: There may be other causes of bloody or dark urine. This list is not all inclusive, and the causes are not presented in order of likelihood. The causes of this symptom can include unlikely diseases and medications. Furthermore, the causes may vary based on age and gender of the affected person, as well as on the specific characteristics of the symptom such as time course, aggravating factors, relieving factors, and associated complaints. Use the Symptom Analysis option to explore the possible explanations for bloody or dark urine, occurring alone or in combination with other problems.