Red urine? Urologist demystifies 'blood in urine'

Discovering blood in the toilet bowl after urination can be a frightening experience, but a urologist advises against immediate panic, emphasizing that hematuria does not automatically signal a grave diagnosis like bladder cancer.

Dr. Su Xin-hao, deputy director of Fengshan Li Jia-wen Urology Clinic, explained that hematuria is broadly categorized into two types: macroscopic (visible to the naked eye, turning urine red, pink, or tea-colored) and microscopic (red blood cells detectable only under a microscope, often found during routine health screenings).

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Seeing blood in the urine first, don't scare yourself, but you can't be careless either.

Several common factors can cause blood in the urine. Urinary tract infections are a frequent culprit, often accompanied by burning sensations during urination, frequent urination, and lower abdominal pain. Kidney or bladder stones can also cause bleeding as they move through the urinary tract, typically presenting with severe flank or abdominal pain. For middle-aged and older men, an enlarged prostate can lead to bleeding due to the fragility of enlarged blood vessels in the prostate.

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The biggest characteristic of hematuria caused by tumors is often 'painless hematuria'. Besides the urine turning red, the body has no pain or discomfort at all.

However, Dr. Su stressed that urinary tract tumors, including bladder or kidney cancer, are the most concerning cause. A key characteristic of tumor-related bleeding is often its "painless" nature, meaning the urine may appear red without any accompanying discomfort. Less serious causes include dietary factors, such as consuming large amounts of red dragon fruit or beets, or certain medications, which can temporarily alter urine color and resolve with increased fluid intake.

Dr. Su strongly warns against ignoring hematuria, even if symptoms temporarily disappear. Bleeding from stones or tumors can be intermittent, leading individuals to believe the issue has resolved. He urges anyone experiencing visible blood in their urine or microscopic hematuria detected in tests to consult a urologist promptly. Examinations may include urine tests, ultrasounds, and potentially cystoscopies to determine the underlying cause and ensure timely treatment.

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Because the bleeding caused by stones or tumors may be 'intermittent' (red today, not red tomorrow). If you ignore it because it doesn't hurt or the symptoms temporarily disappear, you are very likely to miss the golden treatment period.