While it may be the result of something quite benign, it can also be a sign of a more significant issue—so it’s important to follow up when it happens.
This article explores some of the common causes of hematuria in people with penises and offers an overview of how the condition is diagnosed and treated.
Common Causes
The presence of blood in the urine means that bleeding is occurring somewhere in the genitourinary tract. In people with penises, this involves organs such as the kidneys, bladder, ureter, urethra, testicles, and prostate gland.
Among some of the more common causes of hematuria in men are:
Benign prostatic hyperplasia: Also known as an enlarged prostate Cystitis: Also known as a bladder infection Medications: Including penicillin, heparin, and certain chemotherapy drugs Pyelonephritis: Also known as a kidney infection Urinary tract infections (UTIs): Including certain sexually transmitted diseases (STDs) Urolithiasis: Kidney or bladder stones Kidney or bladder trauma: Including injuries caused by vigorous exercise
Rare Causes
There are several rare diseases and genetic disorders that can cause blood loss in the urine.
Glomerulonephritis: A type of chronic kidney diseaseLupus nephritis; A complication of the autoimmune disease lupus involving the kidneysSickle cell anemia; An inherited blood disorderVon Hippel-Landau disease: Another inherited disorder that causes non-cancerous tumors on the kidneys, testicles, and spineCancer: Typically advanced kidney, bladder, or prostate cancer
Diagnosis
There are a number of tests that, when combined with a physical examination and medical history, will help your healthcare provider make an accurate diagnosis.
Urine-based and blood-based tests used to diagnose hematuria include:
Urine dipstick test: A simple test used to detect the presence of blood Urine culture: Used to identify the cause of a bacterial infection Urinalysis: A urine-based test that can detect excessive protein suggestive of chronic kidney disease Urine STD tests: Used to diagnose STDs like gonorrhea or chlamydia Complete blood count (CBC): A blood test that can detect signs of infection (based on an increase in white blood cells) or signs of a blood disorder (based on decreased platelet levels) Blood chemistry tests: A panel of blood tests that can help establish if there is a problem with your kidneys
Depending on the suspected cause, other tests may be ordered, including:
Intravenous pyelogram: An X-ray test in which an iodine-based dye is injected into a vein to detect abnormalities in the genitourinary tract Cystoscopy: An imaging tool that involves the insertion flexible fiber-optic tube into the urethra to visualize the bladder Ultrasound: A non-invasive imagine tool that uses sound waves that can visualize problems in the genitourinary tract such as kidney stones or an enlarged prostate Computed tomography (CT): An imaging technology that composites multiple X-ray images to create three-dimensional “slices” of internal organs
Treatment
The treatment of hematuria is directed by the underlying cause. Treatment of some of the more common causes include:
Antibiotics for UTIs, cystitis, pyelonephritis, and bacterial STDsBPH medications like Flomax (tamsulosin) or Proscar (finasteride)Discontinuation or a dose adjustment for medications that cause hematuriaShockwave therapy or other treatments for bladder or kidney stonesSurgery for severe kidney of bladder injuries
Other treatments are involved with chronic kidney disease, autoimmune disease, genetic conditions, and cancer.
It is important to note that the amount of blood in urine has no direct association with the seriousness of the disorder.
Summary
Blood in the urine (hematuria) is common men. Common causes include an enlarged prostate, urinary tract infections, bladder infections, kidney infections, bladder or kidney stones, bladder or kidney trauma, and certain medications. Less likely causes include chronic kidney disease, lupus, cancer, and genetic disorders like sickle cell anemia.
Hematuria is diagnosed with a physical exam, a review of your medical history, and urine- and blood-based tests. Based on the suspected cause, imaging tests like ultrasound or intravenous pyelogram may be ordered. The treatment of hematuria is directed by the underlying cause.
