What is Gross Hematuria?

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  • Written By: Madeleine A.
  • Edited By: W. Everett
  • Last Modified Date: 19 January 2019
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Gross hematuria refers to the medical term for copious amounts of blood in the urine. In addition, this type of blood in the urine is visible, as opposed to trace hematuria, which may only be seen microscopically. Hematuria refers to any amount of blood in the urine, however, when it referred to as gross hematuria, the amount of blood is great. Generally, large amounts of blood in the urine is not characterized as an actual disease in itself, but a symptom of a medical condition.

This condition can present both with and without pain. Typically, when pain is present, conditions such as urinary tract or kidney infections are frequently the cause. In addition, urolithiasis, or bladder stones may be related to pain as well. When large amounts of blood in the urine occur without pain, bladder, kidney, or prostate cancer needs to be ruled out. Frequently, gross hematuria is not found to be related a serious medical condition, however, it must always be medically evaluated.

Typically, when blood in the urine is caused by urinary tract infection, it is accompanied by foul-smelling urine, burning while urinating, and a persistent urge to urinate. In addition, patients may suffer bladder pain, fever, and chills. Urinary tract infections typically occur when bacteria enters the bladder via the urethra. Treatment for urinary tract infection include antibiotics, fluids, and analgesics for pain and fever. Symptoms usually resolve soon after antibiotic therapy is initiated.


When an enlarged prostate causes gross hematuria, it may block urinary flow because it compresses on the urethra. This condition generally occurs in older men, however, it can affect younger men as well. Other symptoms of prostate enlargement include urinary hesitancy and a constant need to urinate. These symptoms should be evaluated because an enlarged prostate can signal prostate cancer. A delay in seeking a proper diagnosis can mean a delay in medical treatment.

Sometimes blood in the urine can be caused by a kidney infection. In addition to gross hematuria, additional symptoms of kidney infections include flank pain, pain when urinating, and strong-smelling urine. In addition, fever, chills, and nausea can also be present, just like in a bladder infection. Treating a kidney infection promptly is important because kidney damage may occur if left untreated. When kidneys become permanently damaged, the possibility of kidney dialysis becomes a threat.

Occasionally, medications can cause gross hematuria. These include anti-coagulant medications such as Coumadin®, heparin and aspirin. These medications decrease platelet aggregation, which makes it more difficult for the blood to clot. People who are on an aspirin therapy regime for prevention of heart attack and stroke are advised to monitor themselves for signs of abnormal bleeding such as nosebleeds, blood in the stools, and blood in the urine.


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