There are two types of hematuria commonly evaluated by a urologist. Blood that can be seen in the urine is called gross hematuria. Blood that cannot be seen in the urine, except when examined with a microscope, is called microscopic hematuria.
Hematuria, whether gross or microscopic, should be evaluated by a urologist. This involves examination of the entire urinary tract to try to localize the source of the blood. This includes the kidneys, which filters blood to produce urine composed of wastes and extra water. The urine then flows from the kidneys to the bladder through conduit tubes called ureters. The bladder stores urine until releasing it through urination. When the bladder empties, urine flows out of the body through a tube called the urethra at the bottom of the bladder. Blood in the urine should be emanating from one of these structures.
Most people with microscopic hematuria do not have symptoms. Most commonly, it is discovered incidentally during a routine examination. People with gross hematuria have urine that is pink, red, or cola/tea colored due to the presence of red blood cells. Gross hematuria may be painless or may be associated with pain or discomfort in the side, back, or abdomen, or while urinating.