This will be done with both a urinalysis (which looks for abnormal urine contents) and with a microscope, for a more detailed look at the urine. Evaluation of a urine sample is needed to investigate hematuria. Sports Medicine Evaluation The sports medicine physician will perform a thorough history and physical exam of the athlete, often focusing on the genitourinary and gastrointestinal systems of the patient. If the hematuria is related to direct trauma, then pain at the site of impact is expected. Occasionally, athletes will have pain just above the front region of the hip. Symptoms Apart from having blood in the urine, athletes with exercise-induced hematuria usually have no other symptoms. As above, taking some medications may predispose an athlete to exhibiting blood in his/her urine. Hematuria in itself can be caused by other factors apart from exercise, such as urinary tract infections, the presence of a stone in the urinary tract, kidney disease, among others athletes with such conditions may be at higher risk of exhibiting blood in their urine after exercise. Any direct impact to the kidneys, bladder or urethra could potentially cause traumatic hematuria as well. Any of these factors alone or any combination of them may result in hematuria. Weight-bearing, intense activities appear to place an athlete at higher risk than other, less weight-bearing, forms of exercise. Risk Factors Risks of developing hematuria after exercise include long endurance events, very intense events, and/or poor hydration. Sometimes, hematuria is related to a traumatic injury, such as a direct blow or a fall. It is most common in runners, especially those running more than 10,000 meters. Longer and more intense events have been known to more likely cause hematuria.
Some foods may color the urine reddish, and some medications, such as blood thinners, may lead to actual blood in the urine.įor most cases of exercise-induced hematuria, the causes are related to the intensity and duration of activity, as well as the hydration status of the athlete. Sometimes, the breakdown products of red blood cells and muscles may appear in urine, making the urine appear much darker, and this may be mistaken for actual blood. However, some causes do need to be investigated, particularly if the blood in the urine keeps appearing, or does not clear after 72 hours. In general, if the urine clears 72 hours after exercise, there is no need to further investigate.
This has also been called “runner’s bladder,” “marathoner’s hematuria,” and “stress hematuria.”Ĭauses Exercise-induced hematuria may have various causes, ranging from relatively harmless ones to more worrisome ones. What is it? “Exercise-induced hematuria” is a benign condition in which blood is present in the urine (“hematuria”) following exercise.