Blood in the urine (referred to as hematuria) is surprisingly common. In fact, about 13% to 20% of people experience it at one point or another. Blood in the urine can be visible to the naked eye as bright red or brown in color; it may also be microscopic and only detected with urine tests.

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. 

Recap

Possible causes of hematuria in men include a urinary tract infection, bladder infection, kidney infection, kidney or bladder stones, an enlarged prostate, and a bladder or kidney injury. Some medications can also cause blood 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.

Uncommon causes of hematuria in men include chronic kidney disease, lupus nephritis, sickle cell anemia, and cancer of the bladder, kidney, or prostate gland.

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:

The diagnosis of hematuria typically involves a physical exam, a review of your medical history, and various urine and blood tests. If needed, imaging tests like ultrasound, intravenous pyelogram, or cystoscopy may be performed.

  • 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.

The treatment of hematuria can vary by whether the cause is an infection, a bladder or kidney stone, an enlarged prostate, or medications you are taking. The amount of blood in urine has no relation to the severity of a medical condition.

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.

Frequently Asked Questions

  • What causes blood in the urine and pain while urinating for males?
  • The most likely causes include kidney or ureteral stones, or passing blood clots that originate in the ureters.
  • What types of cancer could cause blood in the urine?
  • Cancer in the kidney, bladder, or prostate could cause blood to appear in urine.

The most likely causes include kidney or ureteral stones, or passing blood clots that originate in the ureters.

Cancer in the kidney, bladder, or prostate could cause blood to appear in urine.