Blood in Urine: Causes and When to Seek Help

Hematuria can be painful?

At the beginning of October this year, I experienced discomfort in my lower body and noticed blood in my urine, accompanied by pain.
However, the pain subsided after urination, and there was no further bleeding.
I consulted a doctor and took medication, and there were no issues until early November when I experienced blood in my urine again, with the same symptoms—pain that resolved after urination.
Blood tests showed no abnormalities, but a urinalysis indicated the presence of kidney stones, and I was prescribed medication.
There were no issues in between, but by early December, I felt some discomfort in my lower body after urinating in the morning.
When I urinated a second time, I again noticed blood in my urine and experienced pain, which gradually subsided after two urinations.
Since then, I have had no blood in my urine and no abnormalities.
Could this be a recurrence of kidney stones, or is it something else?

Ahao, 20~29 year old female. Ask Date: 2022/12/05

Dr. Chen Jiansheng reply Urology

Please seek medical attention.

Reply Date: 2022/12/05

More Info

Blood in urine, also known as hematuria, can be a concerning symptom that may indicate various underlying health issues. In your case, the recurrent episodes of blood in urine accompanied by discomfort suggest that there may be an issue related to the urinary tract, such as urinary stones, infections, or other conditions.

Possible Causes of Hematuria
1. Urinary Tract Stones: Kidney stones or bladder stones can cause bleeding when they irritate the lining of the urinary tract. The pain associated with passing urine can also be a symptom of stones. Given that you mentioned having a history of urinary stones, this could indeed be a recurring issue.

2. Urinary Tract Infections (UTIs): Infections can lead to inflammation and bleeding in the urinary tract. Symptoms often include pain during urination, frequent urge to urinate, and sometimes fever. However, you noted that you did not have any pain after urination, which might make a UTI less likely.

3. Bladder or Kidney Issues: Conditions such as cystitis (bladder inflammation), glomerulonephritis (kidney inflammation), or even tumors can lead to hematuria. These conditions might not always present with pain, especially if they are mild.

4. Prostate Issues: In men, prostate enlargement or infections can also lead to blood in the urine, especially if there is discomfort in the lower abdomen.

When to Seek Help
You should seek medical attention if you experience:
- Persistent blood in urine, especially if it is accompanied by pain.

- Severe pain that does not resolve.

- Fever or chills, which could indicate an infection.

- Changes in urinary habits, such as increased frequency or urgency.

- Any other unusual symptoms, such as weight loss or fatigue.

Diagnostic Approach
Given your history and symptoms, it would be prudent to follow up with your healthcare provider. They may recommend:
- Urinalysis: To check for signs of infection, blood, or crystals.

- Imaging Studies: Such as an ultrasound or CT scan to visualize the kidneys and bladder for stones or other abnormalities.

- Cystoscopy: A procedure to look inside the bladder and urethra if other tests do not provide clear answers.

Conclusion
While it is possible that your symptoms are related to urinary stones, it is essential to monitor your condition closely. If you experience another episode of hematuria or any worsening symptoms, do not hesitate to seek medical advice. Early diagnosis and treatment can prevent potential complications and address any underlying issues effectively. Always remember that while some causes of hematuria may be benign, others can be serious, so it is crucial to take this symptom seriously.

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