Blood Clots In Urine

If you are passing blood clots in urine then it is imperative you figure out the cause and get it diagnosed then treated as soon as possible.  There are many cause of blood in urine which differ slightly between male and females.  Generally blood in the urinary tract must be coming from either the kidney, the ureter which connects the kidney with the bladder, the bladder itself, urethra or the prostate which would obviously only be in males.

Hematuria from defects in the kidney itself is sometimes called glomerulonephritis and there are various forms of this illness.  It is quite complicated, but what you need to know is the glomerulus part of the kidney filters blood and sometimes there are holes in the glomerulus due to various disease processes that allow red blood cells to pass thru.  Usually this can cause bleeding, but rarely would it specifically cause clotting.

A stone in the urethra can cause bleeding by causing friction and loss of epithelium.  Often the bleeding is minor and likely there aren’t clots.  Minor bleeding usually causes urine to look like Hawaiian punch.  If you think about red food coloring being put in a glass of water causing the entire glass to turn red that is similar to how much blood is here.  It is quite small.  Furthermore, stones are usually accompanied by pain in the lower back and that pain can be quite severe.  If you have a stone you will know it.

Further down the genitourinary tract we get to the bladder.  As murphy’s law would say that is where the money is.  If you are having more than a small amount of blood clots in your urine then likely this is where the bleeding is coming from.  If your urine is maroon in color as opposed to just simply red or light punch red then the bladder is the most likely culprit.  Now with that being said if you have only lightly bloody urine then it is still possible the bladder is the cause of the bleeding.  Possibilities include a urinary tract infection, cystitis which is an inflammation of the bladder and can be caused by infection or medication or bladder cancer which if caught early will actually have a good prognosis.  This is why it is imperative that you seek medical attention immediately if you have some bleeding.  Should you have burning or pain it could be indicative of a urinary tract infection causing your bleeding.  However, should some clot get stuck in the urethra that could also cause pain and worse also block your plumbing preventing you from urinating.  This would require emergent attention and a placement of a foley catheter.  Once the foley catheter is placed in your urethra and enters your bladder it can be irrigated to wash out the clots.  Bladder cancer workup initially consists of a cystoscopy to view the tumor and if present to be biopsied and removed.  Superficial bladder cancer is easily treatable, but if it invades the muscular layer then that could prove for further complicated treatment.

As we move further down the genitourinary tract we hit the prostate which rarely causes bleeding.  Prostate cancer manifests with urinary retention, difficulty with urinary stream, urinary frequency and is a leading cause of cancer.  Everyone should have a manual prostate exam by age 40.  PSA screening is no longer in vogue and is not the topic of this article.

Finally, urethral bleeding is most commonly caused by trauma from an inserted foley catheter.  If you have been or are hospitalized chances are you may have had one placed and placing or removing a cather is traumatic to the urethra.  Bleeding is more common in those patients taking anticoagulants like coumadin, pradaxa or xarelto.  Ironically if you do have bleeding it is recommended to keep a foley catheter in for compression and allow for healing.  Regardless if you do have blood clots in urine make sure you are seen by your physician or other health care professional