Routine urine occult blood (++++) may be hematuria. Normally, a routine urine test for occult blood has a negative result, which means that the urine is free of red blood cells during the routine urine test. If there is occult blood in urine (++++) it is common in the following cases: First, some women retain urine during menstruation, which can lead to the appearance of red blood cells in the urine because the urine is contaminated by menstruation. The second, common cause is patients with urinary tract infections, which manifest as frequent, urgent and painful urination, and urine routine examination can be seen as positive for urine leukocytes and urine occult blood. The third common cause is urinary stones, such as ureteral stones, which can cause damage to the mucous membrane and lead to positive urine occult blood. Fourthly, patients with kidney diseases such as glomerulonephritis may have occult blood in the urine. Fifth, urological tumors can also cause painless hematuria throughout the urinary tract.