Urethrorrhagia

Urethrorrhagia is a name for irritation and bleeding of the urethra (the passage where urine comes out), seen most commonly in adolescent boys. Your child generally voids clear, yellow urine followed by a few drops of bright red blood at the very end of his urinary stream. There may also be a few tiny dots of blood inside the underwear.

In most cases, we don’t know exactly what causes urethrorrhagia, but it is generally painless and tends to resolve on its own over time without requiring further treatment.

Urethrorrhagia is typically diagnosed based on clinical history alone. However, if there is any uncertainty as to the diagnosis, an ultrasound of the kidneys and bladder can help rule out other causes of bleeding.

During his visit, your child may also complete a uroflow study to measure the urine flow rate and the time needed to empty the bladder, and an ultrasound to see if any urine is left in the bladder. We will also discuss bladder and bowel emptying habits to further understand your child’s condition.

Urethrorrhagia is most often a benign condition that does not require special treatment. We generally advise patients to drink lots of water, in order to keep the urine dilute (clear to very light yellow in color). This helps to minimize any irritation to the lining of the urethra.

Urethrorrhagia can come and go, but usually is self-limiting and does not require prolonged follow-up.

In some cases, patients with a history of urethrorrhagia go on to develop strictures, or areas of narrowing inside the urethra. This typically occurs months or years after the bleeding episode.

Strictures can lead to difficulty with urination, or straining to empty the bladder. For this reason, we generally recommend that patients with urethrorrhagia return to clinic for a follow-up visit, in order to complete a uroflow study (urinating into a special toilet that measures the urinary flow rate) to make sure there is no evidence of narrowing.