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Gross Hematuria

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Gross Hematuria, Pseudohematuria, Red Urine

  • See Also
  1. Microscopic Hematuria
  2. Urinalysis
  • Causes
  • Gross Hematuria
  1. Gross Hematuria confirmed with Urine Red Blood Cells on urine microscopy
  2. Urinary tract source
    1. Urethra or Bladder
      1. Urinary Tract Infection (cystitis)
      2. Urethritis (e.g. Sexually Transmitted Infection)
      3. Bladder Cancer
      4. Bladder stones
      5. Instrumentation
      6. Radiation cystitis
      7. Interstitial Cystitis
      8. Pelvic Fracture
      9. Urethral Stricture
    2. Prostate
      1. Prostatitis
      2. Benign Prostatic Hyperplasia
      3. Hematospermia
    3. Ureter or Kidney
      1. Urolithiasis (Ureterolithiasis, Nephrolithiasis)
      2. Pyelonephritis
      3. Malignancy (e.g. Renal Cell Carcinoma)
      4. Urinary obstruction or strictures
      5. Kidney Trauma
  3. Non-Urinary tract source
    1. Vaginal Bleeding
    2. Rectal Bleeding
  • Causes
  • Asymptomatic Gross Hematuria by Incidence
  1. Acute Cystitis (23%)
  2. Bladder Cancer (17%)
  3. Benign Prostatic Hyperplasia (12%)
  4. Nephrolithiasis (10%)
  5. Benign essential Hematuria (10%)
  6. Prostatitis (9%)
  7. Renal Cancer (6%)
  8. Pyelonephritis (4%)
  9. Prostate Cancer (3%)
  10. Urethral Stricture (2%)
  • Causes
  • Pseudohematuria (non-Hematuria related Red Urine)
  1. Myoglobinuria
  2. Hemoglobinuria
  3. Porphyria
  4. Bilirubinuria
  5. Red diaper syndrome
  6. Foods (Beets, Blackberries, Rhubarb)
  7. Medications
    1. PhenolphthaleinLaxatives
    2. Phenothiazines
    3. Rifampin
    4. Pyridium
    5. Phenytoin
    6. Pyridium
    7. Senna
  • References
  1. Dial (2003) AAFP Board Review, Seattle
  2. Ingelfinger (2021) N Engl J Med 385(2):153-63 +PMID: 34233098 [PubMed]