Blood in Urine (Hematuria) Test

Why this test may be ordered

• As part of a routine exam to check general health, including the health of the urinary tract, kidneys, and liver
• If you see blood in your urine
• If you have symptoms such as painful urination, frequent urination, back pain, or abdominal (belly) pain

Preparation and collection

No special preparation is needed for this test. If your provider has ordered other urine or blood tests, you may need to fast (not eat or drink) for several hours before the test. Your provider will let you know. You may need to stop taking certain medicines before this test; tell your provider about everything you take, but do not stop any medicine unless your provider tells you to.

You will need to provide a urine sample using the 'clean catch' method. A health care professional may give you a cleansing wipe, a small container, and instructions. Wash your hands, open the container without touching the inside, clean the genital area with the wipe, then urinate a small amount into the toilet, stop, and collect the rest into the container. Collect at least an ounce or two. Do not let the container touch your body. Cap the container and return as instructed. If you have hemorrhoids or are menstruating, tell your provider before the test, as outside blood could affect results.

There is no known risk to having a urinalysis or a blood in urine test.

Understanding results

This test checks for blood in your urine (hematuria). Blood may be visible (gross hematuria) or only found under a microscope (microscopic hematuria). Many things can cause blood in urine, and most are not serious, but sometimes it can be a sign of a condition that needs treatment.

• Blood detected: The test found blood cells in your urine (microscopic or gross hematuria). This may be due to a urinary tract infection, kidney disease, liver disease, bladder or kidney stones, prostate problems, or other conditions. It can also be caused by certain medicines, intense exercise, sexual activity, or menstruation. Limitation: This result does not diagnose a specific condition. Further testing is often needed to determine the cause. Possible causes include infection, kidney stones, intense exercise, injury, or more serious conditions such as cancer. Next step: Your healthcare provider may order additional tests, such as imaging or a urine culture, to find the cause of the blood.
• No blood detected: No blood was found in your urine sample. This is a normal finding, but it does not guarantee that there are no other urinary tract or kidney issues. Limitation: A negative result does not rule out all conditions. If you have symptoms, your provider may still recommend further evaluation. Next step: If you have symptoms such as painful urination, back pain, or abdominal pain, discuss them with your provider even if the test is negative.

• Certain medicines, intense exercise, sexual activity, or menstruation can cause blood in urine and may lead to a false positive
• Contamination from skin germs or menstrual blood can affect accuracy
• A single positive result does not diagnose a specific condition; further testing is usually needed to determine the cause

What to do next

If your test result shows blood in your urine, you may need more tests to find out why. Discuss all results with your healthcare provider to understand what they mean for your health.

• What could cause blood in my urine?
• Do I need additional tests if blood is found?
• How should I prepare for the test?

Evidence source

U.S. National Library of Medicine: Blood in Urine (Hematuria) Test