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What causes blood in urine despite having normal urinalysis?

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Posted on Wed, 25 May 2016
Question: Hi,
I am a healthy 44 y/o female and I take no medications. I have worked out with a trainer 2 times per week and done cardio 2-3 times per week for the last 9 years with no problem. I weigh 113 lbs. Two weeks ago, I started urinating blood (it looks red wine...it is very red) for the first urination right after I run. It has happened 4 times in a row over the past two weeks. I only run 30 minutes at 5-6 mph (2.6 miles) on the treadmill so it is not strenuous. It does not happen when I work out with my trainer. My doctor did a urinalysis twice and everything was normal (no muscle breakdown and no detectable blood). It is not a UTI and I have no pain. What could be the cause of this? Thanks for your help!
doctor
Answered by Dr. Matthew J. Mangat (2 hours later)
Brief Answer:
Idiopathic/ runner's hematuria is a possibility.

Detailed Answer:
Hello XXXX and welcome to HCM.
As an Urologist, i can fully understand your concern.


After going through your description of the urine discoloration, i would like to know,if the following tests have been done :

if the urine routine tests were done soon after seeing the discoloration.

1. urine culture.
2. urine for AFB smear and culture.
3. Blood routine,creatinine, RBS,LFT,BT,CT,PT and platelets.
4. ultrasound scan-KUB. or
5. CECT(contrast CT) is done.

If the above tests have been done, kindly send the reports.
If they've not been done,then kindly do them and send the reports.

If you're on any medication,kindly send the list.
After seeing the reports, i can give you an expert opinion.

Wish you well.
Dr.Matthew J. Mangat.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Matthew J. Mangat (5 hours later)
Hi Dr. Mangat,

Thank you for getting back to me. I have had two urine culture and a urine smear and they were normal. They were each done 2 days after the blood was present. All blood work was normal. I am not on any medication at all. I can't get an ultrasound ir CT test in time before this question closes automatically. I just was curious about possible causes. Thank you!
doctor
Answered by Dr. Matthew J. Mangat (27 minutes later)
Brief Answer:
No delay in doing tests.

Detailed Answer:
Hi XXXXXXX

The urinalysis must be done, within half-hour of seeing reddish urine.
Delayed reports are unreliable.
So next time you go for a test,keep this in mind.

Same time you should have the urine culture test.

Both scans give information, regarding any cause for ? bleeding in urinary tract.

Without any report showing blood, you can't call it bleeding from urinary tract.
So only discoloration of urine is noticed.

That can occur with change in diet,like taking beetroots,rhubarb and aloe.
As you're not on any medication,you don't think of that.

Drink 10-12 glasses fluids daily.
Drink more, if you sweat excessively.

Wishing you well.

Dr.Matthew J. Mangat.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Matthew J. Mangat

Urologist

Practicing since :1981

Answered : 1898 Questions

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What causes blood in urine despite having normal urinalysis?

Brief Answer: Idiopathic/ runner's hematuria is a possibility. Detailed Answer: Hello XXXX and welcome to HCM. As an Urologist, i can fully understand your concern. After going through your description of the urine discoloration, i would like to know,if the following tests have been done : if the urine routine tests were done soon after seeing the discoloration. 1. urine culture. 2. urine for AFB smear and culture. 3. Blood routine,creatinine, RBS,LFT,BT,CT,PT and platelets. 4. ultrasound scan-KUB. or 5. CECT(contrast CT) is done. If the above tests have been done, kindly send the reports. If they've not been done,then kindly do them and send the reports. If you're on any medication,kindly send the list. After seeing the reports, i can give you an expert opinion. Wish you well. Dr.Matthew J. Mangat.