Urine, bloody or dark

• In women, the blood may appear to be in the urine when it's actually coming from the vagina .
• In men, the urethra carries both urine and semen out of the body and what may be mistaken for urinary bleeding is sometimes a bloody ejaculation usually due to a prostate problem.

Bladder infections are more common in women than in men and are especially common during pregnancy . Bladder infections are usually accompanied by pain or burning on urination , frequent urgent urination, and occasionally blood in the urine.

Discoloration from drugs or foods can mimic blood in the urine.

Common Causes:

• kidney stone
• bladder stones that lodge in the urethra
• tumors of the urinary tract.
• glomerulonephritis
• bladder tumor
• chronic or recurrent urinary tract infection
• cystitis
• pyelonephritis
• urethritis
• enlarged and infected prostate (prostatitis)
• post-streptococcal GN
• urethral ulceration
• hypercalciuria (increased amounts of calcium in the urine)
  • distal renal tubular acidosis
  • use of diuretics ("water pills")
  • hyperparathyroidism
  • hypothyroidism
  • hypercalcemia
  • hypertension
  • juvenile rheumatoid arthritis
  • medullary cystic disease
  • metabolic acidosis
  • neoplasm
  • sarcoidosis

• acute tubular necrosis
• "hardening" of the urinary opening (meatal stenosis)
• trauma
  • fracture of the pelvis
  • renal contusion (bruised kidney)
  • renal fracture ("broken" or torn kidney)
  • urethral trauma

• surgical procedures, including catheterization, circumcision, surgery, and renal biopsy
• drugs
  • anticoagulants
  • cyclophosphamide
  • metyrosine
  • oxyphenbutazone
  • phenylbutazone
  • thiabendazole

Note: There may be other causes of bloody or dark urine. This list is not all inclusive, and the causes are not presented in order of likelihood. The causes of this symptom can include unlikely diseases and medications. Furthermore, the causes may vary based on age and gender of the affected person, as well as on the specific characteristics of the symptom such as time course, aggravating factors, relieving factors, and associated complaints. Use the Symptom Analysis option to explore the possible explanations for bloody or dark urine, occurring alone or in combination with other problems.

Home Care:
Follow prescribed therapy to treat the underlying cause.

Drink lots of fluids unless it is difficult to breathe or unless the ankles are swollen. Fruit juices, such as cranberry juice, can be quite effective.

For "honeymoon cystitis " (a urinary infection following sexual intercourse), avoid sexual activity until symptoms subside.

For injury, obtain medical treatment (possibly surgery). A kidney stone may pass or it may need to be removed.

For an enlarged and infected prostate, see your health care provider for antibiotics (possibly surgery if it continues to recur).

For discoloration from drugs or foods, make sure of the origin of the red color.

Call Your Healthcare Provider If:

• there is blood in the urine. This should never be ignored.

What to Expect:
The medical history will be obtained and a physical examination performed.

Medical history questions documenting dark or bloody urine in detail may include:

• time pattern
  • When did the urine become dark or bloody?
  • Did it occur suddenly?

• quality
  • What color is the urine?
  • Is there any pain associated with urination?
  • Is it consistently the same color throughout the day?
  • Is the quantity of urine per day decreased or increased?
  • Is any blood visible?
  • Is there an odor?

• aggravating factors
  • Are medications being used that could cause this change in color?
  • Have foods been eaten that could cause this change in color (such as colored candy, beets, berries, rhubarb)?

• relieving factors
  • Does a change in diet change the color of the urine?
  • Does a change in medication change the color of the urine? (Note: NEVER change medications without first consulting your health care provider.)

• other
  • What other symptoms are also present?
    • Is there pain when urinating ?
    • Is there pain in the abdomen ?
    • Is there back pain ?
    • Is there a fever ?
    • Has there been a decreased fluid intake or decreased thirst ?
    • Has there been a decreased appetite ?
    • Is there nausea , vomiting , or diarrhea ?

  • What medications are being taken?
  • Have you had previous urinary problems or kidney problems?
  • Do you have any allergies ?
  • Have you had previous similar symptoms?
  • Has there been a recent injury?
  • Has there been any recent diagnostic or surgical procedures involving the urinary tract?
  • Has there been a change in sexual activities?

A physical examination will be performed, and vital signs (temperature, pulse , rate of breathing, blood pressure ) may be monitored. With a pre-existing kidney infection , a more detailed history and physical are needed and extra laboratory studies may be necessary. In women with a discharge, an examination of the vagina and any discharge is usually necessary.

Diagnostic tests that may be performed include:

• blood studies such as a CBC and blood differential
• urinalysis
• cystoscopy
• kidney biopsy
• X-rays of the kidneys
• IVP
• abdominal ultrasound
• CT scan of the abdomen

Intervention:
If urinary tract infection is confirmed, antibiotics may be prescribed. If appropriate, pain medications will be administered.

After seeing your health care provider:
You may want to add a diagnosis related to bloody or dark urine to your personal medical record.


This is an illustration of the female urinary tract. The female and male urinary tracts are relatively the same except for the length of the urethra. The positioning in the body and relative size of the organs are also demonstrated.