Blood In The Urine: What Could Cause It?

By Medically reviewed by Panel Perubatan Hello Doktor

Blood In The Urine: What Could Cause It?

Realising that there is blood in your urine is extremely alarming whether you’re a man, woman, young or old. In medical classification, the presence of blood in the urine, also known as hematuria, can be split into two groups, namely Gross hematuria and Microscopic hematuria. Gross hematuria refers to the presence of blood in the urine that can be very easily seen, discolouring your urine slightly pinkish or dark brown, resembling the colour of Coca Cola. Microscopic hematuria, on the other hand, refers to the presence of blood in the urine only detectable through laboratory tests.

Where is the blood in the urine coming from?

Blood in the urine can originate from several organs, especially those that make up the urinary system such as the kidney, the ureter, the bladder and the urethra. However, the presence of blood in your urine can also be due to organs around the urinary system especially near the bladder, as well as inflammatory processes affecting the body or the urinary system.

Less serious causes of hematuria

Vigorous exercise

Excessively vigorous exercise can lead to hematuria. This condition is also known as runner’s bladdermarathoner’s bladder or even stress bladder. Usually, the presence of blood in the urine will disappear after a period of rest of around 72 hours after intense activity. However, it is also worth noting that if you have a pre-existing kidney condition or any other problems related to the urinary system, vigorous exercise can further exacerbate the damage of this condition and lead to the formation of hematuria.


Trauma to the genital or other parts of the body close to the bladder or the kidney can also result in bleeding into the urinary system. Trauma can be caused by contact sports, vigorous sex, mishaps or accidents during sex, and accidents in general.

More serious causes of hematuria


Infection can take place in any part of the genito-urinary system, such as the kidney (Pyelonephirits), bladder infection (Cystitis) and the infection of the urethra (urethritis). This also include sexually transmitted infections.


Stones can be formed and dislodged to other parts of the urinary system starting from the kidney, ureter, bladder or urethra. Usually, the presence of stones is accompanied by the presence of heavy alternating pain, localised to the site of the stone.


Aside from the cancer of the urinary system such as kidney cancer or bladder cancer, cancer of the surrounding structures of the urinary system may also cause hematuria. They can grow and invade organs such as the bladder and subsequently lead to the presence of blood in the urine. Such cancers include prostate cancer and bowel cancer.

Other Diseases

  • Red blood cell disorder such as Sickle Cell Anaemia can lead to massive hemolysis, the destruction of the red blood cells in the body, which subsequently gives rise to the presence of blood in the urine.
  • Autoimmune conditions such as Systemic Lupus Erythematosus (SLE)can damage the kidney and lead to leakage of blood into the urinary system.
  • Inherited disorders such as Alport syndrome and Polycystic Kidney Disease can also cause blood to be present in the urine.
  • Even prostate enlargement can encroach the bladder and cause the same symptom.

When you consult a doctor after experiencing symptoms, in addition to regular examination, necessary tests will be performed to accurately identify the cause of your hematuria. Although most of the time the cause is not serious, there are serious causes for the presence of blood in the urine, which necessitate attention.

Hello Health Group does not provide medical advice, diagnosis or treatment.

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Review Date: April 24, 2019 | Last Modified: November 15, 2019

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