Is Blood in Urine Always a Sign of Bladder Infection? - Urology

Share to:

The presence of blood in the urine is it a sign of cystitis?


Hello Doctor: I have been experiencing lower back pain (on the right side) for about a month, and then one day I suddenly had severe pain in my lower abdomen.
A few days later, I noticed visible blood in my urine.
The doctor suggested it might be cystitis, but I don't experience pain while urinating; I only occasionally feel a slight stinging sensation in my bladder and a warm sensation during urination, but there is no pain during the process.
So, is it possible to have cystitis without pain during urination? After taking antibiotics for a week, I had another urine test, which showed no hematuria (and my back pain has resolved), but both RBC and WBC counts were slightly above normal, and there were bacteria present (the day before, I went hiking, which was not high intensity but was a long-awaited sweating exercise; could this be related?).
Does this indicate that I still have hematuria? The next day, feeling uneasy, I had another check-up, and the report showed normal results.
However, I realized that I had consumed a large amount of water at that time, and I would like to know if this could lead to inaccurate results.
I read online that drinking water can affect specific gravity but is less likely to impact RBC and WBC results, is that correct? Currently, when I lie flat, I occasionally feel a slight heaviness in my lower back, but otherwise, I have no other symptoms.
Based on the doctor's assessment, do you think I have cystitis? I am very concerned that it could be a more serious condition (the possibility of kidney stones has been ruled out with relevant tests).

Nǚz, 20~29 year old female. Ask Date: 2021/09/04

Dr. Du Shixi reply Urology


Hello: Cystitis can potentially cause hematuria, so a urinalysis should be performed to check for inflammation.
After recovery, a follow-up urine test should be conducted to check for red blood cells.
There are many causes of hematuria, and it is difficult to definitively say that hematuria is solely due to cystitis.
For more information, you can refer to https://www.femh.org.tw/epaperadmin/viewarticle.aspx?ID=2349.
Wishing you good health.

Reply Date: 2021/09/04

More Info


Blood in urine, known as hematuria, can be a concerning symptom and is not always indicative of a bladder infection. While bladder infections (cystitis) can cause hematuria, there are several other potential causes that should be considered, especially in the context of your symptoms and medical history.

In your case, you mentioned experiencing lower back pain, sudden severe abdominal pain, and then the appearance of visible blood in your urine. The absence of pain during urination is somewhat atypical for a bladder infection, which often presents with dysuria (painful urination), urgency, and frequency. However, it is important to note that not all patients with a bladder infection will experience pain. Some individuals may have mild symptoms or even be asymptomatic, particularly in cases of uncomplicated cystitis.

The presence of red blood cells (RBCs) and white blood cells (WBCs) in your urine, along with bacteria, suggests some form of urinary tract involvement. The fact that your urine showed no blood after a week of antibiotics could indicate that the initial hematuria was resolving, but the presence of RBCs and WBCs still indicates some underlying issue. It is also worth noting that physical activity, such as hiking, can sometimes lead to transient hematuria due to minor trauma or dehydration, especially if you are not accustomed to such activities.

Regarding your concern about the accuracy of urine tests after consuming large amounts of water, it is true that hydration can dilute urine, potentially affecting the concentration of certain substances. However, it typically does not significantly alter the presence of RBCs or WBCs unless the dilution is extreme. The fact that your follow-up tests showed normal results may suggest that the initial findings were transient or related to a mild infection or irritation that resolved with hydration and antibiotics.

Given your symptoms and the resolution of back pain, it is reasonable to consider that you may have had a mild urinary tract infection or another transient issue that has since improved. However, persistent or recurrent hematuria, even if it is not accompanied by other symptoms, warrants further investigation. Conditions such as kidney stones, glomerulonephritis, or even more serious concerns like tumors in the urinary tract should be ruled out, especially if you have a history of urinary symptoms.

In summary, while blood in urine can be a sign of a bladder infection, it is not definitive. Your symptoms, the results of your urine tests, and the absence of pain during urination suggest that you may have experienced a mild urinary issue that has since improved. However, if you continue to have concerns or if symptoms recur, it is advisable to follow up with your healthcare provider for further evaluation. They may recommend imaging studies or additional tests to ensure that there are no underlying conditions that need to be addressed.

Similar Q&A

Am I Experiencing a Urinary Tract Infection?

On Wednesday, I experienced frequent urination throughout the day. The next morning, I noticed that my urine was red (I had been holding it in last week). Occasionally, there were dark blood streaks. I went to the hospital, where I had a urinalysis and an X-ray. The doctor said t...


Dr. Fu Shizhang reply Urology
Based on the symptoms, it is indeed possible. If a urine test has already been conducted, it should provide clarity. It is recommended to make a determination based on the urine test results.

[Read More] Am I Experiencing a Urinary Tract Infection?


Understanding Blood in Urine: Causes and What to Do Next

A few days ago, I noticed that my urine was blood-tinged. The night before, I only felt some pressure in my lower abdomen. However, when I woke up the next day and went to the bathroom for the second time, I found that my urine was completely blood-red and painful. After that, I ...


Dr. Lin Hexing reply Urology
Hello Ms. Micky: Based on the symptoms you described, it seems you may be experiencing signs of a bladder infection. While increasing your fluid intake at the onset of symptoms may lead to spontaneous resolution, it is still advisable for you to visit a hospital and consult a uro...

[Read More] Understanding Blood in Urine: Causes and What to Do Next


Understanding Urinary Pain and Blood: Is It a UTI Related to Sexual Activity?

I have been experiencing a cramping sensation towards the end of urination for the past couple of days, and when I wipe, I notice a bit of blood on the toilet paper. Does this indicate a urinary tract infection, and could it be related to sexual activity?


Dr. Chen Xiuyi reply Urology
Hello! Painful urination and blood upon wiping may be caused by a urinary tract infection (UTI). Common causes of UTIs include insufficient fluid intake, holding in urine, poor hygiene practices, and sexual activity. Reports from abroad have indicated that female students who are...

[Read More] Understanding Urinary Pain and Blood: Is It a UTI Related to Sexual Activity?


Understanding Recurrent Urinary Tract Infections and Hematuria

Hello Doctor: I experience urinary tract infections every month, and each episode is acute, with visible hematuria and significant pain. My health check-ups have consistently shown urinary occult blood. I have undergone kidney ultrasounds, abdominal X-rays, and urine cultures at ...


Dr. Du Shixi reply Urology
Hello: Your condition may be one where there are no symptoms each time, but it hasn't fully resolved. It is recommended to return for a follow-up appointment after taking the medication to confirm that your urine has returned to completely normal. If there is still blood or ...

[Read More] Understanding Recurrent Urinary Tract Infections and Hematuria


Related FAQ

Urine Occult Blood

(Urology)

Infection

(Urology)

Bladder

(Urology)

Urine Test

(Urology)

Hematuria

(Urology)

Urinary Tract Infection

(Pediatrics)

Interstitial Cystitis

(Urology)

Holding Urine

(Urology)

Bleeding

(Urology)

Bladder Infection

(Obstetrics and Gynecology)