Blood in the urine

Blood in my urine (haematuria): Should I be worried?

If you've ever seen blood in your urine, you may be worried. Blood in urine is also called haematuria. It can sometimes be a sign of a serious medical condition.

What is haematuria?

Haematuria refers to the presence of blood in your urine. Urine is usually clear, yellow, or pale, but haematuria can make it turn pink, red, or even brown. The blood in your urine may be visible to the naked eye (visible haematuria) or only detectable under a microscope or on a urine dipstick test (non-visible haematuria). A trace of blood on a urine dipstick test is not usually significant and does not need further investigation.

What causes blood in the urine (haematuria)?

There are many different causes of blood in the urine, including:

• Urinary tract infections (UTIs)

• Kidney stones

• Enlarged prostate (in men)

• Cancer of the bladder, kidney or ureter

• Medications, such as blood thinners

• Injury to the urinary tract

• Vigorous exercise

Is blood in the urine (haematuria) a serious problem?

The seriousness of blood in the urine depends on its underlying cause. Visible blood in the urine needs urgent investigation in those aged over 45. With non-visible blood in the urine, the indication for further investigations is less clear and is tailored to the individual. It is important to see a doctor to rule out more serious causes, such as cancer and to discuss further investigations.

When should I see a doctor about haematuria?

You should see a doctor if you notice any blood in your urine, even if it's just once. You should also see a doctor if you have any other symptoms along with haematuria, such as:

• Pain when you urinate

• Pain in your abdomen

• Changes in your urinary habits
  

If you're over 45 or have risk factors for urinary tract cancers, such as a family history of cancer, it is important to see a doctor right away if you notice any blood in your urine.

How is haematuria investigated?

The treatment of haematuria depends on its underlying cause. For example, if you have a urinary tract infection your doctor may prescribe antibiotics. If you have kidney stones, your doctor may suggest continued monitoring or a procedure to remove the kidney stones.

To investigate the cause further a urologist will usually organise a camera test of the bladder and waterpipe (urethra). This is carried out under a local anaesthetic and takes only 1-2 minutes of the camera being inside the patient. The camera test is known as a flexible cystoscopy and the camera itself is about the same size as a urethral catheter which is often used to measure urine output in hospitals. The main risks of a flexible camera test are pain on passing urine after the test, a urinary tract infection of some bleeding in the urine. A urologist carries out the test and can tell you the findings immediately and if you need any further tests.

To investigate the kidneys and the tubes draining the kidneys (ureters) a urologist will organise an imaging test such as an ultrasound of the kidneys, ureter and bladder (US KUB) or a CT urogram. The test requested will be dependent on your level of risk of finding cancer in the kidneys or ureter which is dependent on your presentation, age, genetics and other factors such as smoking.

If you have cancer, your doctor may recommend further tests such as surgery, chemotherapy, radiation therapy, or a combination of these treatments, depending on the type of cancer that is found. The most common cancer that is found due to non-visible or visible blood in the urine is bladder cancer and it is important that this is detected and treated as early as possible.

Schedule an appointment to discuss your risk if you have had non-visible blood or visible blood in the urine.

Mr Ivo Dukic is an experienced Consultant Urologist who regularly investigates patients with blood in their urine. You can schedule an appointment with him for expert, bespoke advice through his Top Doctors profile or make an appointment through the Harborne Hospital, HCA Healthcare or the Priory Hospital, Edgbaston, Circle Health Group.

Have any questions?

If you have any questions or wish to make an appointment please get in contact.