Hematuria (Blood in Urine) Evaluation | Long Island

Blood in the Urine: A Finding Worth Evaluating

Seeing blood in your urine — or being told your urine test shows red blood cells — can be unsettling. The good news is that many causes are common and treatable. A thoughtful evaluation helps clarify the cause and decide whether anything more needs attention.

Hematuria — the medical term for blood in the urine — can have many different causes, and most of them are completely benign. It might be something as simple as a urinary tract infection, kidney stones, or an enlarged prostate. An evaluation is the best way to understand what is going on, get the right care, and put your mind at ease.

Dr. Kashani offers evaluation based on the patient's situation — which may include cystoscopy, imaging, and urine testing. The goal is to understand the cause clearly and efficiently. Most patients have a clear answer within one to two visits.

Worth getting checked: Even if it happened only once or seems to have resolved, it is still worth mentioning and having evaluated. In many cases the explanation is straightforward, and checking helps provide clarity.

Hematuria blood in urine evaluation urologist Long Island Dr. Kashani

What Does It Look Like?

Blood in the urine shows up in two ways — either you can see it, or it is found on a routine urine test. Both are worth evaluating, and both are very common.

Visible Blood

Urine that appears pink, red, or darker than usual. It can be unsettling to see, but there are many possible explanations. Most cases turn out to have a straightforward, treatable cause. The next step is simply to understand where it is coming from.

Blood Found on a Lab Test

Sometimes red blood cells are detected on a routine urine test even though the urine looks completely normal. This is very commonly found during routine check-ups. Just like visible blood, it deserves a follow-up to identify the cause — and most of the time, the cause turns out to be benign.

What to Expect

However the blood was found, the evaluation is often more straightforward than patients expect. Many find that the explanation is clear and manageable. Dr. Kashani performs in-office cystoscopy so you are not sent to multiple facilities, and most patients have answers within one to two visits.

What Causes Blood in the Urine?

The urinary tract includes the kidneys, ureters, bladder, prostate (in men), and urethra. Bleeding can come from anywhere along this system. Evaluation helps identify where the blood is coming from and what, if anything, needs attention.

Common Cause

Kidney Stones

Kidney stones are a common cause of blood in the urine. As a stone moves through the ureter it can cause irritation and bleeding — often with flank pain, but sometimes without any other symptoms. Imaging is often able to identify stones clearly.

If kidney stones are identified, Dr. Kashani can help with next steps — from monitoring to treatment options. Learn about kidney stone treatment →

Common Cause

Urinary Tract Infection (UTI)

Infections can sometimes cause blood in the urine, especially when accompanied by burning or urinary urgency. If the blood clears completely after treatment and a follow-up urine test is normal, further evaluation may not be needed in some cases.

In men, a UTI with hematuria is worth evaluating further — since UTIs are less common in men and sometimes have an underlying contributing cause.

Common in Men

Enlarged Prostate (BPH)

An enlarged prostate can sometimes contribute to blood in the urine. In men over 50 with hematuria and urinary symptoms, BPH is often part of the picture — and evaluation can help clarify what role it may be playing.

BPH and hematuria can coexist with other contributing causes. A thorough evaluation looks at the full picture rather than assuming one explanation covers everything. Learn about BPH treatment →

Checked Via Cystoscopy or Imaging

Bladder Cancer

Part of the reason urologists evaluate hematuria is to look for less common but important causes. Bladder cancer is found in a small minority of cases — and when identified early, it is highly treatable. Cystoscopy is a brief in-office procedure that can provide clear, direct answers.

Most patients who have a cystoscopy leave with reassuring results. The procedure takes about 5 minutes and most people return to normal activities the same day.

Upper Tract

Kidney Conditions

The kidneys can sometimes be the source of blood in the urine. Imaging is very helpful at evaluating the kidneys for possible causes. Some kidney conditions are managed by a urologist; others involve a kidney specialist (nephrologist). Either way, evaluation helps identify the right path forward.

When the cause appears to be a medical kidney condition rather than a urologic one, Dr. Kashani coordinates the appropriate referral so care stays connected.

Other Causes

Other Urologic Causes

Other possible causes include bladder stones, urethral conditions, radiation-related changes, vigorous exercise, and certain medications including blood thinners. Even when a medication or activity might seem like the explanation, evaluation can still be helpful to understand the full picture.

Being on blood thinners does not rule out other contributing causes — evaluation is still often recommended to make sure nothing is overlooked.

What the Evaluation May Involve

When evaluating blood in the urine, testing may include a combination of urine testing, imaging, and looking inside the bladder. These options look at different parts of the urinary tract and are often used together, depending on the situation.

Procedure Option — In-Office

Cystoscopy

Cystoscopy allows Dr. Kashani to look directly inside the bladder and urethra using a thin, flexible camera passed through the urethra under topical local anesthesia. It can help identify irritation, stones, growths, or other causes of bleeding. It is a brief in-office procedure and is often better tolerated than patients expect. The procedure takes approximately 5 minutes, and most patients return to normal activities the same day.

Cystoscopy provides direct information about the bladder lining that imaging alone cannot — it is an important part of understanding what is going on.

Imaging

CT Urogram

A CT urogram is a commonly used imaging test when evaluating blood in the urine. It looks at the kidneys and ureters in more detail and can identify kidney tumors, kidney stones, ureteral abnormalities, and other findings that cannot be seen on cystoscopy. It is ordered through radiology with results reviewed by Dr. Kashani.

CT urogram and cystoscopy look at different parts of the urinary tract — one sees the upper tract, the other the lower tract — and are often used together to get a more complete picture.

Urine Testing

Urine Cytology

A urine sample is sent for analysis of the cells in the urine. It is simple, non-invasive, and adds a helpful layer of information alongside the other testing. It requires no special preparation — just a urine sample — and is an easy addition to the overall evaluation.

Urine cytology is non-invasive and requires no special preparation. It helps provide a more complete picture of what may be contributing to the finding.

Starting Point

Urinalysis & Urine Culture

A urine test is often the starting point because it helps confirm the finding and look for signs of infection or other clues. It identifies red blood cells, white blood cells (which may suggest infection), protein (which may suggest a kidney-related cause), and other useful information. A urine culture is ordered when infection is suspected.

The urine test is a helpful first step — it confirms the finding and can point toward the most likely cause, which helps guide what comes next.

Frequently Asked Questions — Hematuria

Is blood in urine always serious?

The most common causes of blood in the urine are benign — things like a urinary tract infection, kidney stones, or an enlarged prostate. That said, it is worth getting evaluated, because a thoughtful review can identify the cause and provide clarity. Most patients end up with a straightforward explanation and a clear plan.

What is the difference between gross and microscopic hematuria?

Gross hematuria means blood is visible to the naked eye — urine that looks pink, red, or darker than usual. Microscopic hematuria means red blood cells are found on a routine urine test even though the urine looks normal. Both types are worth following up on, and both typically have a benign explanation that a standard evaluation will identify.

What does a hematuria evaluation involve?

The evaluation may include cystoscopy (a brief look inside the bladder), CT urogram (imaging of the kidneys and urinary tract), and urine cytology (a lab analysis of urine cells). Depending on the situation, not all tests may be needed. Dr. Kashani performs cystoscopy in the office under local anesthesia — it takes about 5 minutes and most patients go back to normal activities the same day.

Can a UTI cause blood in urine?

Yes — urinary tract infections are a common cause of blood in the urine. A UTI can sometimes explain the finding, but follow-up may still be recommended depending on the full picture. In some cases the blood clears completely after treatment and no further evaluation is needed. In other cases, additional follow-up is helpful to make sure there is nothing else contributing.

Is cystoscopy painful?

Cystoscopy is performed under topical local anesthesia in the office. Most patients describe it as uncomfortable rather than painful — similar to pressure or the urge to urinate. The flexible cystoscope is thin and well-tolerated. The procedure takes about 5 minutes. There may be mild burning with urination for a day or two afterward, which resolves on its own.

Can kidney stones cause blood in the urine?

Yes — kidney stones are a very common cause of blood in the urine. As a stone moves through the ureter, it can cause irritation and bleeding — often with flank pain, though sometimes without any other symptoms. Imaging can be very helpful at identifying stones and understanding their location.

Why Choose Dr. Kashani for Hematuria Evaluation?

The goal of evaluation is not just to order tests, but to help patients understand what the findings may mean and what, if anything, needs to happen next. Dr. Kashani offers in-office cystoscopy and coordinated evaluation so the process feels more straightforward — no need to go to multiple facilities for different parts of the visit.

In-office flexible cystoscopy for convenience and comfort
Coordinated imaging and radiology review
Urine cytology with clear results follow-up
Clear explanation of findings and next steps
Two convenient Long Island locations — Rockville Centre and Carle Place
Same-week appointments available

Dr. Mahyar Kashani hematuria specialist Long Island

Hematuria Specialist on Long Island