Seeing blood in urine (called hematuria) is never normal and should be treated as urgent, especially for a man, because causes range from minor infections to cancers.

If you or someone else is currently peeing red, brown, cola‑colored, or blood‑streaked urine, the safest move is to contact a doctor, urgent care, or ER today , especially if there is pain, clots, fever, or trouble peeing. This is not something to “wait and see.”

Main possible causes

In men, blood can come from anywhere along the urinary tract (kidneys, ureters, bladder, prostate, urethra). Common categories include:

  • Infections
    • Urinary tract infection (UTI), kidney infection (pyelonephritis), or prostate infection (prostatitis) can all cause burning with urination, urgency, frequency, pelvic or back pain, fever, and blood in urine.
* More likely if there is painful urination, foul‑smelling or cloudy urine, fever, or feeling generally unwell.
  • Stones (kidney or bladder)
    • Hard mineral “stones” can scrape the lining of the urinary tract, causing severe flank or groin pain, nausea, and visible blood in urine.
* Classic picture: waves of sharp side/back pain, sometimes with an urgent need to pee but passing only small amounts.
  • Prostate problems
    • Enlarged prostate (BPH) or prostatitis can lead to weak stream, starting and stopping, needing to push, frequent night urination, and sometimes blood in urine.
* Prostate cancer can also cause blood in urine or semen, especially in older men, sometimes with few other early symptoms.
  • Cancers of the urinary tract
    • Bladder, kidney, or prostate cancers are important causes doctors must rule out, especially in men over 35–40 or anyone who smokes or has long‑term chemical exposure.
* Painless visible blood in urine (even once) is a classic red‑flag symptom for bladder or kidney cancer and always needs prompt urology evaluation.
  • Kidney diseases
    • Diseases that damage the kidney filters (glomerulonephritis, IgA nephropathy, inherited diseases like Alport or polycystic kidney disease) can cause cola‑ or tea‑colored urine, swelling, high blood pressure, and foamy urine.
* Sometimes these conditions cause only microscopic blood detected on a urine test, but they can still be serious.
  • Injury or heavy exercise
    • A direct blow or accident involving the back or abdomen can make the kidneys bleed into the urine.
* Intense exercise (especially in runners) can very rarely cause temporary hematuria, but this should still be checked once to rule out other causes.
  • Medications and blood‑clotting issues
    • Blood thinners (warfarin, heparin, some antiplatelet drugs like aspirin) and certain chemotherapy drugs can cause bleeding in the urinary tract.
* Clotting disorders or very low platelets can also show up first as blood in urine.
  • Other causes
    • Recent urinary procedures (catheter, cystoscopy), radiation, or severe pelvic infections can trigger bleeding.
* In younger patients, inherited blood disorders (like sickle cell disease) or structural kidney abnormalities can present with hematuria.

When it’s an emergency

Seek immediate emergency care (ER) if any of these happen with blood in urine:

  • Passing large clots or the urine stream suddenly stops, with a bladder that feels full
  • Strong flank/back or groin pain, especially with nausea or vomiting
  • High fever, chills, feeling very unwell or confused
  • Inability to pee, or only drops, despite a strong urge
  • Recent major injury to back, belly, or groin

These situations can signal blocked urine flow, severe infection, or major internal injury and need urgent treatment.

What a doctor usually does

Evaluation is aimed at finding where the blood is coming from and why.

  • History and exam
    • Questions about pain, fever, clots, urinary symptoms, sexual history, medications, and personal/family history of kidney or bladder problems.
* Physical exam of abdomen, back, genital area, and prostate (for men) as needed.
  • Tests
    • Urinalysis and urine culture to check for infection, protein, crystals, or abnormal cells.
* Blood tests to assess kidney function and blood counts.

* Imaging, such as ultrasound or CT scan, to look for stones, tumors, or structural issues.

* Cystoscopy (small camera into the bladder) to look for bladder or urethral sources of bleeding, especially in adults with visible hematuria.
  • Treatment
    • Antibiotics for infections, pain control and sometimes procedures for stones, specific therapies for kidney disease, or surgery/oncology care for cancers.
* Stopping or adjusting a medicine that’s contributing to bleeding, under medical supervision.

Practical steps if this is happening

While online info can explain possibilities, only in‑person care can safely diagnose and treat hematuria.

  • Do not ignore even a single episode of red, pink, or cola‑colored urine.
  • Take a photo of the toilet bowl or urine if possible; this can help the clinician.
  • Note timing (start, end, or throughout the stream), pain, clots, fever, medications, and any recent injuries or new exercises to report at the visit.
  • Avoid strenuous activity and stay hydrated unless a doctor has told you to restrict fluids.

Bottom line

  • Blood in a man’s urine can come from infections, stones, prostate issues, kidney disease, medications, injuries, or cancers.
  • It is always a reason to get prompt medical evaluation, even if it does not hurt.
  • If there is severe pain, clots, fever, inability to pee, or recent trauma, emergency care is the safest choice.

Information gathered from public forums or data available on the internet and portrayed here.