Blood in Urine (Haematuria)
What should I do if I have blood in my urine?
If you see blood in your urine, you should see your GP immediately. Your GP will normally investigate blood in the urine as a matter of urgency by taking a history and performing a physical examination. Bloods tests to assess you blood counts and renal function will be obtained as well as urine tests looking for infection (urine culture) as well as cancer cells (cytology).
If you have a proven infection, you may be started on antibiotics. However, if the urine test result comes back showing no evidence of infection or you continue to show blood in your urine, you will be referred to an urologist.
What could have caused the blood in my urine?
50% of patients with visible blood in the urine will have an underlying cause identified but with non-visible blood in the urine only 10% will have a cause identified.
The chance of finding cancer in patients with visible blood in the urine is 10-15% and for non-visble blood in the urine is 2-4%.
Although there are many potential causes for blood in the urine, those most often identified are:
Urinary tract (bladder) infection
Enlarged prostate in men
Cancers of the bladder, kidney or prostate
Stones in the kidneys or bladder
Inflammation of the kidneys (nephritis)
Urinary tract injuries
Blood disorders and other less common causes
How is blood in the urine investigated?
Your Urologist will perform some or all of the following assessments:
Detailed history including about your urinary symptoms, risk factors for any cancers, general medical history and medications
A physical examination (including rectal or vaginal examination)
Blood tests (if not already performed by your GP)
Examination of the urine for cancer cells
X-rays or scans such as CT or ultrasound scans
When your tests have been completed, your urologist will advise you on what to do next. If an abnormality requiring further treatment is detected, your urologist will advise you on what treatment is necessary and what this would involve. If no abnormality is detected simply a follow-up to check resolution of blood in your urine in a few months may be required.