“I’m bleeding!!!”

Seeing discolored urine is not an uncommon event.   A male patient came into our office one day because he noticed blood in his urine. This was the first time it had ever happened, so he was, understandably, alarmed. “It’s bright red,” he described, and added that there were no blood clots. He denied any associated abdominal pain, pain with urination, frequent urination, difficulty urinating or penile discharge. He was not concerned about having a sexually transmitted infection. His physical exam was completely normal. His urine sample no longer showed any evidence of blood.

“What to do?”

“Bright red” urine usually means the blood is coming from the lower part of the urinary system-around the bladder. The most common reasons are urinary tract infection, a sexually transmitted disease, a kidney stone or a prostate problem. Although it is rare, cancer can also cause red urine. To narrow the possibilities, he was referred to a urologist to obtain a CT scan of abdomen/pelvis and a bladder scope(cystoscopy).

“Other Helpful Clues”

Lots of other clues can help find the cause of his bleeding. His age, associated symptoms, medications, character of the pain, other health conditions are important considerations when evaluating someone with bloody urine.

“The Diagnosis”

The CT scan revealed a small stone in the bladder. Medicines in case of pain in the future and to help the stone pass were provided. And eventually the stone passed on its own. This case was particularly interesting because he had no pain.

If you experience blood in your urine or you are having any of the symptoms discussed above, see a healthcare provider at City Care Family Practice for further evaluation. If bleeding is severe or if you feel very ill, lightheaded or have abdominal pain, you should proceed to the Emergency Room for immediate evaluation.

Author McCall Helstrom, PA-C McCall is a Certified Physician Assistant, born and raised in Minnesota. She received her Master of Physician Assistant Studies from Des Moines University in Iowa in 2021. In her free time, McCall enjoys spending time with family and friends, traveling, trying new cuisines, going on walks, running, hiking, and skiing.

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