What Causes Blood in Urine without Pain?

Reviewed on 5/12/2021
Blood in the urine (hematuria) can be caused by many different conditions. Urinary tract infections (UTIs) and kidney stones can be painful, but exercise-induced hematuria and side effects of medications may not be.
Blood in the urine (hematuria) can be caused by many different conditions. Urinary tract infections (UTIs) and kidney stones can be painful, but exercise-induced hematuria and side effects of medications may not be.

Blood in the urine (hematuria) can have numerous causes. Urine may appear pink, reddish, or brown in cases of gross hematuria. Blood may not be visible but is seen when urine is examined under a microscope in cases of microscopic hematuria. 

There are numerous causes for blood in urine, such as:

Some of these conditions such as urinary tract infections and kidney stones can be painful, and some conditions such as exercise-induced hematuria and side effects of medications may not be. If you notice blood in your urine, see a doctor to diagnose the underlying cause and determine the proper treatment. 

What Symptoms May Accompany Blood in Urine?

Blood in the urine (hematuria) may cause the urine to appear pink, reddish, or brown. But not all cases of hematuria can be seen with the naked eye. In some cases, blood in the urine can only be seen under a microscope. 

Other symptoms that may accompany blood in urine depend on the underlying cause and may include:

  • Urinary tract infection (UTI)
    • Urinary urgency or frequency
    • Pain or a burning sensation on urination
    • Smelly or cloudy urine
    • Pain in the lower abdomen
    • Tiredness
    • Feeling unwell (malaise)
  • Kidney stones
    • Sharp pains in the back, side, lower abdomen, or groin
    • Urinary frequency
    • Pain while urinating
    • Difficulty urinating 
    • Cloudy or bad-smelling urine
    • Nausea
    • Vomiting
    • Fever
    • Chills
  • Sexually transmitted diseases (STDs) such as chlamydia
    • Abnormal vaginal or penile discharge 
    • Burning sensation when urinating
    • Pain and swelling in one or both testicles in men
    • Rectal pain, discharge, bleeding
  • Internal trauma 
    • Pain in the abdomen
  • Cancer
    • Urinary frequency and urgency
    • Pain or burning during urination
    • Difficulty urinating or having a weak urine stream
    • Waking to urinate multiple times during the night
  • Enlarged prostate (benign prostatic hyperplasia, or BPH)
    • Difficulty urinating
    • Urinary frequency 
    • Difficulty fully emptying the bladder
  • Exercise-induced hematuria 
    • Usually there are no other accompanying symptoms 
    • Occasionally, athletes will have pain just above the front region of the hip
    • If the hematuria is related to trauma to the area, there may be pain at the site of impact 



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How Is Blood in Urine Diagnosed?

If blood in urine (hematuria) is suspected, tests to diagnose the cause may include: 

What Is the Treatment for Blood in Urine?

Treatment for blood in urine depends on the cause. 

  • Urinary tract infection (UTI)
    • Antibiotics
    • Over-the-counter pain relievers 
  • Kidney stones
    • Over-the-counter (OTC) or prescription pain medications 
    • Antibiotics if due to infection
    • Surgical removal 
  • Sexually transmitted diseases (STDs) such as chlamydia
    • Antibiotics 
  • Internal trauma 
    • Treatment depends on severity 
    • Rest and medical observation
    • Surgery
  • Cancer
  • Enlarged prostate
    • Lifestyle changes
      • Limiting alcohol, caffeine, and carbonated beverages
      • Limiting artificial sweeteners
      • Getting regular exercise
      • Consuming less liquids in the evening 
    • Medications to reduce the size of the prostate and relax the bladder
    • Surgery, usually only in severe cases that have not responded to medications
  • Exercise-induced hematuria 
    • Usually goes away on its own with rest and without treatment within 24 to 72 hours following the activity
    • If trauma is involved (such as in contact sports), treatment depends on the severity of the injury
  • Certain drugs
    • Treatment may involve stopping the medication or changing the dosage
    • Do not stop taking any prescribed medication or change the dose without first talking to your doctor

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Reviewed on 5/12/2021