What causes blood in men’s urine?

blood in the urine hematuria) is surprisingly common. In fact, about 13% to 20% of people have experienced it at some point. Blood in urine is visible to the naked eye and is bright red or brown; it may also be microscopic and can only be detected by a urine test.

While this can be some very benign outcome, it can also be a sign of a more important problem – so it’s important to follow up when it happens.

This article explores some common causes of hematuria in penile patients and outlines how to diagnose and treat this condition.

Common causes

blood in the urine means the bleeding is somewhere genitourinary system road. For people with a penis, this involves organs such as the kidneys, bladder, ureters, urethra, testicles, and prostate.

Some of the more common causes of hematuria in men include:

  • benign prostatic hyperplasia: Also known as enlarged prostate
  • Cystitis: Also called a bladder infection
  • Medications: including penicillin, heparin, and certain chemotherapy drugs
  • pyelonephritis: Also known as kidney infection
  • Urinary tract infections (UTIs): including certain sexually transmitted diseases (STDs)
  • Urolithiasis: Kidney or bladder stones
  • Kidney or bladder trauma: including injuries from strenuous exercise


Possible causes of hematuria in men include urinary tract infections, bladder infections, kidney infections, kidney or bladder stones, enlarged prostate gland, and bladder or kidney damage. Some medicines can also cause blood in the urine.

rare cause

There are several rare diseases and genetic disorders that can cause blood loss in the urine.

  • glomerulus nephritis: a chronic kidney disease
  • lupus nephritis; Complications of lupus, an autoimmune disease involving the kidneys
  • Sickle Cell Anemia; Inherited Blood Disorders
  • Von Hippel-Landau disease: another genetic disorder that causes noncancerous tumors of the kidneys, testes, and spine
  • Cancer: Usually advanced kidney, bladder, or prostate cancer


Less common causes of hematuria in men include chronic kidney disease, lupus nephritis, sickle cell anemia, and cancer of the bladder, kidney, or prostate.


There are many tests combined with a physical exam and medical history that will help your healthcare provider make an accurate diagnosis.

Urine and blood tests used to diagnose hematuria include:

  • Urine dipstick test: a simple test to detect the presence of blood
  • Urine culture: used to determine the cause of bacterial infection
  • Urinalysis: A urine-based test that detects excess protein that suggests chronic kidney disease
  • Urine STD test: used to diagnose STDs such as gonorrhea or chlamydia
  • Complete blood count (CBC): A blood test that can detect signs of infection (based on increased white blood cells) or signs of blood disease (based on low platelet levels)
  • Blood chemistry tests: A set of blood tests can help determine if there is a problem with your kidneys

Depending on the reason for the suspicion, other tests may be ordered, including:

  • Intravenous pyelography: an X-ray test in which an iodine-based dye is injected into a vein to detect urogenital tract abnormalities
  • cystoscopy: an imaging tool that involves inserting a flexible fiber optic tube into the urethra to visualize the bladder
  • Ultrasound: A non-invasive imaging tool that uses sound waves to visualize problems in the genitourinary tract, such as kidney stones or an enlarged prostate
  • Computed tomography (CT): An imaging technique that combines multiple X-ray images to create three-dimensional “slices” of internal organs


The diagnosis of hematuria usually involves a physical examination, reviewing your medical history, and various urine and blood tests. Imaging tests such as ultrasound, intravenous pyelography, or cystoscopy can be done if needed.


Treatment of hematuria depends on the underlying cause. Treatments for some of the more common causes include:

  • Antibiotics for urinary tract infections, cystitis, pyelonephritis, and bacterial STDs
  • BPH medications, such as Flomax (tamsulosin) or Proscar (finasteride)
  • Discontinuation or dose adjustment of drugs causing hematuria
  • Shockwave therapy or other treatments for bladder or kidney stones
  • Surgery for severely damaged kidneys

Other treatments involve chronic kidney disease, autoimmune diseases, genetic diseases, and cancer.

It is important to note that the amount of blood in the urine is not directly related to the severity of the disease.


Treatment of hematuria may vary depending on whether the cause is an infection, bladder or kidney stones, an enlarged prostate gland, or the medications you are taking. The amount of blood in the urine is not related to the severity of the medical condition.


Blood in the urine (hematuria) is common in men. Common causes include an enlarged prostate gland, urinary tract infections, bladder infections, kidney infections, bladder or kidney stones, bladder or kidney trauma, and certain medications. Less likely causes include chronic kidney disease, lupus, cancer and genetic disorders such as sickle cell anemia.

Hematuria is diagnosed by physical examination, review of medical history, and urine and blood tests. Depending on the suspected cause, imaging studies such as ultrasound or intravenous pyelography may be ordered. Treatment of hematuria depends on the underlying cause.

Frequently Asked Questions

  • What causes blood in the urine and pain when urinating in men?

    The most likely causes include kidney or ureteral stones, or a blood clot originating from the ureter.

  • What types of cancer can cause blood in the urine?

    Kidney, bladder, or prostate cancer can cause blood to appear in the urine.