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Visible hematuria causes red urine if the bleeding is fresh. Depending on the extent of bleeding, the urine color may range from a light rosè to a deep burgundy. If the bleeding is old, the urine color often is cola colored or iced tea colored. Sometimes, when hematuria is extensive, it can be accompanied by blood clots. At times, hematuria is only witnessed by seeing bloodstains on one’s underwear or appearing on the toilet tissue when wiping after urination. Most hematuria is painless. When there is pain associated with hematuria, it is often a sign of a kidney stone or a urinary tract infection. The presence of hematuria should be thought of as a red flag that mandates a careful evaluation to rule out serious and life-threatening causes. So all cases of hematuria should be investigated. The presence of hematuria with fever often signifies a urinary tract infection and the presence of nausea and vomiting accompanying the hematuria is often indicative of a kidney stone.
