What Causes Blood in Urine without Pain?

Blood in the urine (hematuria) may cause the urine to appear pink, reddish, or brown. But not all cases of hematuria can be seen with the naked eye. In some cases, blood in the urine can only be seen under a microscope. 

Other symptoms that may accompany blood in urine depend on the underlying cause and may include:

• Urinary tract infection (UTI)
  • Urinary urgency or frequency
  • Pain or a burning sensation on urination
  • Smelly or cloudy urine
  • Pain in the lower abdomen
  • Tiredness
  • Feeling unwell (malaise)
• Kidney stones
  • Sharp pains in the back, side, lower abdomen, or groin
  • Urinary frequency
  • Pain while urinating
  • Difficulty urinating 
  • Cloudy or bad-smelling urine
  • Nausea
  • Vomiting
  • Fever
  • Chills
• Sexually transmitted diseases (STDs) such as chlamydia
  • Abnormal vaginal or penile discharge 
  • Burning sensation when urinating
  • Pain and swelling in one or both testicles in men
  • Rectal pain, discharge, bleeding
• Internal trauma 
  • Pain in the abdomen
• Cancer
  • Urinary frequency and urgency
  • Pain or burning during urination
  • Difficulty urinating or having a weak urine stream
  • Waking to urinate multiple times during the night
• Enlarged prostate (benign prostatic hyperplasia, or BPH)
  • Difficulty urinating
  • Urinary frequency 
  • Difficulty fully emptying the bladder
• Exercise-induced hematuria 
  • Usually there are no other accompanying symptoms 
  • Occasionally, athletes will have pain just above the front region of the hip
  • If the hematuria is related to trauma to the area, there may be pain at the site of impact 

If blood in urine (hematuria) is suspected, tests to diagnose the cause may include: 

• Urine test
• Digital rectal exam to check for prostate problems in men
• Pelvic exam in in women
• Cystoscopy: a thin tube with a camera and light on the end (cystoscope) is inserted into the bladder to check for cancer cells or other problems
• Imaging tests to check for a tumor, kidney or bladder stone, or an enlarged prostate
  • Ultrasound
  • Computerized tomography (CT) scan 
  • Magnetic resonance imaging (MRI) scan  
• Kidney biopsy for suspected kidney disease

Treatment for blood in urine depends on the cause. 

• Urinary tract infection (UTI)
  • Antibiotics
  • Over-the-counter pain relievers 
• Kidney stones
  • Over-the-counter (OTC) or prescription pain medications 
  • Antibiotics if due to infection
  • Surgical removal 
• Sexually transmitted diseases (STDs) such as chlamydia
  • Antibiotics 
• Internal trauma 
  • Treatment depends on severity 
  • Rest and medical observation
  • Surgery
• Cancer
  • Intravesical therapy 
  • Chemotherapy 
  • Radiation therapy 
  • Immunotherapy 
  • Targeted therapy 
• Enlarged prostate
  • Lifestyle changes
    • Limiting alcohol, caffeine, and carbonated beverages
    • Limiting artificial sweeteners
    • Getting regular exercise
    • Consuming less liquids in the evening 
  • Medications to reduce the size of the prostate and relax the bladder
  • Surgery, usually only in severe cases that have not responded to medications
• Exercise-induced hematuria 
  • Usually goes away on its own with rest and without treatment within 24 to 72 hours following the activity
  • If trauma is involved (such as in contact sports), treatment depends on the severity of the injury
• Certain drugs
  • Treatment may involve stopping the medication or changing the dosage
  • Do not stop taking any prescribed medication or change the dose without first talking to your doctor