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Hematuria and Bladder Cancer

Last updated: February 2022

A bladder cancer diagnosis can come about in different ways. You may have symptoms that lead to testing. Your doctor may find signs during a routine exam. Other times, treating a different issue uncovers bladder cancer.

For those of you who experienced signs of bladder cancer before your diagnosis, we wondered about your experience.

To learn more, we turned to the BladderCancer.net Facebook page. We asked community members to share: "What were the symptoms that led to you getting diagnosed with bladder cancer?"

What is hematuria?

Hematuria is the medical term for the presence of blood in the urine. It can have several causes, including bladder cancer. Other causes may include urinary tract infection (UTI), prostate infection, kidney disease, and kidney or prostate cancer. Many of you shared a misdiagnosis of recurrent UTIs.2

Blood in the urine was the most common response to our Facebook prompt. Research shows that 85 percent of people with bladder cancer patients report.1

"Looked like pure blood in urine at midnight. 12 hours later, cancer!"

"A stream of ruby-red pee."

"UTIs and spasms. I was misdiagnosed twice too. They said it was just several UTIs over a few months.”

"Treated by GP for UTI off and on for 3 months."

"Blood in the urine that urgent care said was a UTI."

Why does bladder cancer cause hematuria?

Blood in the urine is a hemorrhaging of the tumor. When the blood vessels of a tumor rupture, that blood ends up in the urine. Early on, cancer blood vessels are delicate. Small tears occur easily. As a tumor grows and invades nearby tissues and blood vessels, this causes bleeding. Whether in small or large amounts, the blood exits through the urine.1,3

Large or visible hematuria

Large or visible hematuria is also called gross hematuria. They may appear pink, red, or brown in the toilet. When visible, the color varies depending on:

  • Amount of blood in the urine
  • Length of time blood has been in the urine
  • Urine level of acidity

When blood is visible in the urine, you should contact your doctor.2

"When urinating, I bled like crazy."

"Toilet full of blood."

Microscopic hematuria

Contrary to gross hematuria, microscopic hematuria is invisible to the naked eye. Blood cells are visible only through a microscope. Most adults have microscopic hematuria in routine urinalysis. It is troubling to find more than 3 blood cells per high-power field in several urine samples. These levels require further testing.1

"Blood in my urine by test, but never visible."

Blood clots

A blood clot develops if enough blood is present in the urine. A large clot blocks urine flow. This results in severe pain and the inability to urinate. Many of you passed blood clots in your urine before your bladder cancer diagnosis.2

"Large amounts of blood in my urine. I was peeing blood clots."

"All of a sudden, one day, my urine was bright red with what looked like red grapes, which were really blood clots."

"Blood in urine to the point I could not pass the clots."

Learning together

We appreciate all the responses to our Facebook prompt. Your comments sparked curiosity about hematuria and bladder cancer. Thank you for the chance to learn together.

Was hematuria the symptom that lead to your bladder cancer diagnosis? Tell us about your experience in the comments below, or share your story with the community.

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