Generally speaking, hematuria is called “visual hematuria”, which refers to the presence of more red blood cells in the urine, which can be seen with the naked eye as bright red or strong tea-colored. What is easily overlooked is the “microscopic hematuria” in which red blood cells are found in the urine under a high-powered microscope. In pediatric patients, hematuria is usually seen in acute nephritis; in adolescents or middle-aged people, hematuria should be considered as non-specific bacterial infections of the urinary system, tuberculosis and stones; in women, if it occurs during the newlywed or childbearing period, it is mostly due to inflammation of the renal pelvis, bladder and urethra. If hematuria is accompanied by bladder irritation symptoms such as frequency, urgency and painful urination, urinary tract infection should be considered; if it is accompanied by back pain, percussion pain in the kidney area or fever, it is more likely to be pyelonephritis; if only bladder irritation symptoms lack systemic infection symptoms, it is more likely to be cystitis; if hematuria occurs after severe colic, it is more likely to be kidney or ureteral stones; if there is pain during urination, sudden interruption of urine flow or difficulty in urination, it is more likely to be bladder or urethra If hematuria occurs after bowel movement or sexual intercourse, it is often posterior urethritis; if hematuria occurs when standing and disappears when lying down, it should be considered as renal prolapse; if hematuria occurs after strenuous exercise, it is post-exercise hematuria or kidney stone; if there is prolonged difficulty in urination first and then hematuria, it should be considered as prostate disease or urinary tract infection. Among the countless causes of hematuria, we should be alert to a kind of painless hematuria, which is clinically called “painless carnal hematuria” when there is no obvious cause for the sudden appearance of carnal hematuria, but no other manifestations such as pain, etc. Painless carnal hematuria is mostly seen in elderly patients, and is usually regarded as an important warning sign of urinary tumor, which should be paid special attention to. Older people are a high-risk group for tumors, and the most common urological tumors include bladder cancer, kidney cancer, ureteral cancer, prostate cancer and so on. Among them, bladder cancer is the most common, which is often manifested as hematuria of the naked eye throughout urination. Many patients have long time hematuria symptoms, some have hematuria 2-3 times a year, “no pain, no itch, just take some anti-inflammatory medicine”, and do not care and do not go to hospital for examination, but when they go to hospital for examination only when the number of hematuria increases significantly, they are often advanced urological tumors, and many have lost the opportunity of surgery, which is very regrettable. Therefore, we remind that we must pay attention to painless carnal hematuria. Therefore for people over 40 years old, when there is painless intermittent hematuria, they should first consider the presence of urological tumors. To further clarify the diagnosis, the following tests can also be done: 1. Repeatedly searching for cancer cells in urine, if cancer cells are found in fresh urine, it will help the diagnosis of bladder cancer. 2.Imaging examination, including intravenous pyelogram with X-ray, CT of urinary tract, MR of urinary tract, ultrasound of urinary tract. 3.Cystoscopic speculation, which can directly detect the site of bleeding and its nature. 4.Other tests: CT scan or kidney biopsy can also be done if the source of the hematuria cannot be determined or is suspected to be from the kidney. The occurrence of painless hematuria is not terrible, even if it is a urological tumor. Through current medical treatment, many urological tumors can be cured, and with the application of advanced technology, we can take many minimally invasive treatment methods to treat urological tumors without the need for surgery to open the abdomen, so that trauma is reduced to the lowest level and patients do not have to experience huge surgical trauma, making many elderly and frail patients also able to This has made it possible to treat many elderly and frail patients in a timely and effective manner. Hematuria is a warning signal issued by the body. Don’t ignore this important warning signal or be afraid to seek medical treatment and miss the best time for treatment. In fact, the application of advanced technology makes tumor treatment less scary.