Blood in the urine (hematuria): a warning sign not to ignore

The presence of blood in the urine, medically called hematuria, is a sign that often worries those who notice it. Sometimes it is visible to the naked eye, while other times it is discovered only through a routine urine test. In any case, it should never be underestimated.

Understanding what it means and when to see a specialist is the first step in taking care of your urological health.

What is hematuria?

Hematuria refers to the presence of red blood cells in the urine.
It can appear in two forms:

• Macroscopic hematuria: the blood is visible, and the urine appears pink, red, or "cola-colored."

• Microscopic hematuria: the blood is not visible to the naked eye and is detected only through laboratory tests.

Both forms require attention, even if there is no pain or other symptoms.

What are the most common causes?

Blood in the urine can have many causes and may involve different parts of the urinary tract (kidneys, ureters, bladder, prostate, urethra). The most frequent include:

• Urinary tract infections

• Kidney or bladder stones

• Prostate inflammation

• Trauma

• Intense physical exertion

• Kidney diseases

• Tumors of the urinary tract (bladder, kidney, prostate)

It is important to note that even without pain, hematuria can be the first and only sign of a significant condition, especially after the age of 50.

Blood in the urine: when to be concerned

It is always advisable to see a doctor, but a urological evaluation becomes essential if:

• The episode recurs over time

• It is not associated with a urinary infection

• It occurs in people over 40–50 years old

• The patient is a smoker or a former smoker

In these cases, one should not wait for the symptom to disappear on its own.

How is it diagnosed?

The diagnostic pathway is personalized based on age, symptoms, and the patient's medical history, and may include:

• Urine test and urine culture

• Blood tests

• Ultrasound of the urinary system

• CT scan or other imaging tests

• Cystoscopy (when indicated)

The goal is not only to identify the cause but also to rule out serious conditions and intervene early if necessary.

Why is it important not to delay

Many urological conditions, including cancers, are treatable with excellent outcomes if diagnosed early. Ignoring blood in the urine or attributing it to minor causes without a specialist evaluation may delay diagnosis.

A final message

Blood in the urine is not a disease, but a signal.
Paying attention to it, without panic but with care, is an act of prevention.

When in doubt, consulting a urologist is always the right choice.