Urine, bloody or dark

Alternative names:

blood in the urine; hematuria

Home care:

Follow prescribed therapy to treat the underlying cause.

Drink lots of fluids unless it is difficult to breathe or unless the ankles are swollen. Fruit juices, such as cranberry juice, can be quite effective.

For "honeymoon cystitis" (a urinary infection following sexual intercourse), avoid sexual activity until symptoms subside.

For injury, obtain medical treatment (possibly surgery). A kidney stone may pass or it may need to be removed.

For an enlarged and infected prostate, see your health care provider for antibiotics (possibly surgery if it continues to recur).

For discoloration from drugs or foods, make sure of the origin of the red color.

Call your health care provider if:

• there is blood in the urine. This should never be ignored.

What to expect at your health care provider's office:

The medical history will be obtained and a physical examination performed.

Medical history questions documenting dark or bloody urine in detail may include:

• time pattern
  • When did the urine become dark or bloody?
  • Did it occur suddenly?

• quality
  • What color is the urine?
  • Is there any pain associated with urination?
  • Is it consistently the same color throughout the day?
  • Is the quantity of urine per day decreased or increased?
  • Is any blood visible?
  • Is there an odor?

• aggravating factors
  • Are medications being used that could cause this change in color?
  • Have foods been eaten that could cause this change in color (such as colored candy, beets, berries, rhubarb)?

• relieving factors
  • Does a change in diet change the color of the urine?
  • Does a change in medication change the color of the urine? (Note: NEVER change medications without first consulting your health care provider.)

• other
  • What other symptoms are also present?
    • Is there pain when urinating?
    • Is there pain in the abdomen?
    • Is there back pain?
    • Is there a fever?
    • Has there been a decreased fluid intake or decreased thirst?
    • Has there been a decreased appetite?
    • Is there nausea, vomiting, or diarrhea?

  • What medications are being taken?
  • Have you had previous urinary problems or kidney problems?
  • Do you have any allergies?
  • Have you had previous similar symptoms?
  • Has there been a recent injury?
  • Has there been any recent diagnostic or surgical procedures involving the urinary tract?
  • Has there been a change in sexual activities?

A physical examination will be performed, and vital signs (temperature, pulse, rate of breathing, blood pressure) may be monitored. With a pre-existing kidney infection, a more detailed history and physical are needed and extra laboratory studies may be necessary. In women with a discharge, an examination of the vagina and any discharge is usually necessary.

Diagnostic tests that may be performed include:

• blood studies such as a CBC and blood differential
• urinalysis
• cystoscopy
• kidney biopsy
• X-rays of the kidneys
• IVP
• abdominal ultrasound
• CT scan of the abdomen

Intervention:
If urinary tract infection is confirmed, antibiotics may be prescribed. If appropriate, pain medications will be administered.

After seeing your health care provider:
You may want to add a diagnosis related to bloody or dark urine to your personal medical record.