Many men, women, and children are told by their primary care physician of incidental finding of blood in the urine (hematuria) in routine laboratory examinations. Now, is this cause for concern? What is a proper way to address it?

Presence of blood cells in the urine of more than five red blood cells per high power field in formal urine analysis (UA) is not normal. However, in the majority of patients, this is due to benign conditions, such as urinary tract infection, kidney stones, prostate enlargement, inflammation, or certain non-cancerous kidney conditions.

Patients on blood thinners are specially at higher risk for urinary bleeding. In general, urologists get more concerned when patients with a history of smoking (active or former) have blood in their urine. This is because carcinogens within cigarettes are a well-documented cause of bladder cancer and cancers of the upper urinary tract.

Blood in your urine can be microscopic (not visible) or gross (reddish color of urine or dark red with clots). It can be painful, bleeding or painless. However, any persistent presence of blood in the urine or gross hematuria warrants a complete history and physical exam (including pelvic and rectal exam) and a visit to a urologist.

He or she will likely request cross-sectional imaging of the urinary tract (CT urogram), and cystoscopic examination of the bladder. It is extremely important that you take persistent presence of blood in your urine seriously and see a urologist to assure of its cause. More importantly, stop smoking immediately. All carcinogens cigarettes eventually end up in your bladder and sit there and damage your bladder.

Contact Dr. Tajkarimi, Top Urologist in Northern Virginia, Maryland and Washington, D.C. Dr. Tajkarimi has served thousands of men, women and children in the DC/VA/MD/PA/WV region for the past 16 years.