Bloody urine in men: Causes and considerations

November 27, 2021

Healthcaretoday, Dr Goh Eng Hong, Urologist, Prince Court Medical Centre, Bloody urine, Hematuria, Men's health, UTI, Kidney stones, Prostate health, BPH, Prostate cancer, Bladder cancer, Men's health matters, Urinary health, Kidney injury, Catheter care, stay hydrated,

Blood in the urine, known as hematuria, can be concerning for men and may arise from various underlying conditions. Understanding the causes is crucial for effective diagnosis and treatment.

By Dr Goh Eng Hong,
Consultant Urologist,
Prince Court Medical Centre, Kuala Lumpur.

Blood in the urine, known as hematuria, can be concerning for men and may arise from various underlying conditions. Understanding the causes is crucial for effective diagnosis and treatment. Here’s a closer look at what can lead to bloody urine in men and when to seek medical attention.

Common causes of hematuria in men
1. Urinary tract infection (UTI)
While UTIs are more common in women, men can also be affected, particularly if they have prostate issues or have recently undergone catheterization. Symptoms may include:

Urgent and frequent urination
Pain or burning sensation
Cloudy or strong-smelling urine
Severe cases can lead to kidney infections, causing back pain, nausea, fever, and chills.

2. Kidney and bladder stones
When waste products in urine crystallize, they can form stones in the kidneys or bladder. Larger stones may cause:

Blood in urine
Lower back pain
Persistent stomach pain
Nausea or vomiting

Symptoms can worsen if the stones obstruct the urinary tract.

3. Exercise-induced hematuria
Known as post-exertional hematuria, this condition can occur after intense physical activity. It is often linked to dehydration and typically resolves within a few days. If bleeding persists beyond two weeks, medical advice should be sought.

4. Enlarged prostate (Benign Prostatic Hyperplasia - BPH)
BPH is common in older men and can press against the urethra, leading to difficulty urinating and potential bleeding. Symptoms include:

Frequent urination, especially at night
Weak urine flow
A feeling of incomplete bladder emptying

5. Recent catheterization
Catheters can introduce bacteria into the urinary tract, leading to infections that may cause hematuria. Symptoms are similar to those of UTIs and may include lower back or abdominal spasms.

6. Kidney injury
Conditions like glomerulonephritis can damage the kidneys, impairing their ability to filter waste. Symptoms may include:

Puffiness in the face
Reduced urination
Shortness of breath

Chronic cases may go unnoticed for years.

7. Medications
Certain medications, such as blood thinners and NSAIDs, can lead to hematuria. If you suspect your medication is causing this issue, consult your doctor for alternatives.

8. Prostate cancer
With 1 in 10 men diagnosed in their lifetime, prostate cancer often presents with few symptoms initially. When they do occur, they can resemble BPH symptoms, along with:

Dull pelvic pain
Painful ejaculation
Blood in semen

9. Bladder cancer
Early-stage bladder cancer may present as blood in the urine, often accompanied by other urinary symptoms. Advanced symptoms can include:

Inability to urinate
Lower back pain
Swelling in the feet

Treatment options
Treatment for hematuria varies based on the underlying cause, including:

Antibiotics for infections
Surgery for kidney stones
Medications or procedures for prostate issues
Chemotherapy or radiation for cancer

Although hematuria is rarely indicative of severe illness, it’s vital to consult a healthcare professional if you notice blood in your urine. Diagnostic tests, including urine analysis and imaging, can help determine the cause and guide appropriate treatment.

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