Blood in Urine - Haematuria
Blood in the urine (haematuria) is divided into two types -
- Visible haematuria (macroscopic haematuris) - blood that you can see with your eye
- Non-visible haematuria (microscopic haematuria) - blood that you cnnot see that is detected by dipstick testing or seen under the microscope.
Visible blood in the urine is very serious and should never ignored. It is vital that you see a urologist for thorough investigation. Visible haematuria is often a result of serious underlying problems - around a quarter of patients with visible blood in the urine may have a cancer. Prompt diagnosis is therefore important.
Urinary blood that is not visible and detected by dipstick teting or microscopy is less ominous but can be a signal of a urinary tract abnormality particularly if you have as pain or urinary symptoms. If you are over 40 years old and have blood detected in the urine on more than two occasions you should be investigated by a urologist.
Causes of blood in the urine
Common causes include -
Investigation of haematuria
We will listen carefully to your and perform a detailed physical examination. Repeat urine testing (microbiology or cytology ) may be repeated.
The lining of the bladder needs to be inspected with a fine flexible telescope under local anaesthesia (flexible cystoscopy). This will diagnose bladder tumours, bleeding from the prostate and bladder stones.
Patients with microscopic haematuria undergo an ultarasound scan of the kidney - This may diagnose kidney tumours and some kidney stones. If there is a history of flank pain we may organise an x-ray looking for kidney or ureteric stones.
Patients with visible haematuria need to have a CT scan with contrast. This is the most detailed study of the urinary system and gives more information than ultrasound alone.