Red Urine Has Many Causes: Some Life Threatening, Some Harmless

Red urine sometimes means blood in the urine, but sometimes it doesn’t.

Either way, you need to find out the cause of red or rust colored urine.

Some causes of red/blood in the urine are serious, including cancer; while some causes are quite benign (harmless).

These include repeated jarring from exercise. This happened to me some years ago when I was pedaling super furiously on a stationary bike, jostling it around: equipment I normally didn’t use.

A visit to the restroom right after revealed blood stains on my panties, but no blood or red in the urine, nor any red staining after that visit.

“Any trauma, regardless of how seemingly trivial, may cause bleeding within the urinary tract,” says Andrew Stephenson, MD, urologist, associate professor, Department of Surgery, School of Medicine; Member, GU Malignancies Program, Case Comprehensive Cancer Center.

“Gross (visible) blood in the urine after trauma is a reason to seek medical attention.”

What do these symptoms really mean?

Dr. Stephenson: Microscopic blood cells in the urine is very common and may not be associated with any disease process within the urinary tract — about 5-10 percent of patients with microscopic hematuria (blood in urine) will have an identifiable cause (e.g., kidney stone, bladder cancer, etc.).

Gross blood in the urine is usually associated with urinary tract pathology (e.g., kidney, bladder or prostate disease) or stones or infection.

What percentage of people who have kidney/bladder/prostate cancer, have this symptom?

Blood in the urine from prostate cancer is uncommon in the absence of advanced disease.

Most patients with bladder or kidney cancer will have microscopic blood cells present in the urine.

Is this a very rare, or very common (or some range in between) symptom of kidney/bladder/prostate cancer?

3-5 red blood cells per high-powered field on microscopic examination of the urine on more than one occasion is an indication for further investigations.

How often or what percentage of diabetics have the symptom?

Very uncommon in the absence of infection.

Is this a common symptom of kidney stones?

Yes. Also, abdominal pain or flank pain will be present if the stone has passed from the kidney into the ureter.

According to Ohio Health Online, here are more causes:

Red color: Porphyria is a skin and nervous system disease; beets, blackberries, rhubarb pie; Ex-lax and other laxatives; some prescription drugs including antipsychotics (Thorazine); and the anesthetic Diprivan; chronic poisoning from mercury or lead.

Blood: Strenuous exercise in addition to fierce stationary bike pedaling, such as distance running and jumping drills.

The site says: “Distance runners are most at risk, but anyone who exercises vigorously can have some urinary bleeding.” Strenuous exercise is a leading cause of the symptom.

Blood: Urinary tract infections, cancer of the kidney or bladder (occasionally), and finally, a leading cause of visible hematuria in children is kidney inflammation resulting from a viral/bacterial infection.

See a doctor when: Two or more incidents of the symptom occur, regardless of time lapse in between; visible hematuria lasting beyond 24 hours; urine color changes not triggered by medications, dyes or food.

dr. glickmanDr. Stephenson’s clinical and research focus is the treatment of prostate, bladder, kidney and testes cancer. He has published over 100 articles in peer-reviewed journals.



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