Haematuria Assessment

What is haematuria?

Haematuria is passing blood in your urine. 

Macroscopic haematuria is blood that can be seen in urine. It can cause the urine to appear red, pink or dark in colour. If there is a lot of bleeding, clots can sometimes form, which can be difficult to pass.

Sometimes, abnormal numbers of blood cells can be detected using a urine dipstick or a microscope. This is called microscopic haematuria.

Both macroscopic (visible) and microscopic (non-visible) haematuria require investigation to exclude a sinister cause.

What are the causes of haematuria?

• Urinary tract infection
• Inflammation of the bladder or kidneys
• Kidney and bladder stones
• Benign prostatic enlargement
• Cancers of the kidney, ureter, bladder or prostate
• Trauma or recent surgery
• Medications including blood thinners
• Radiotherapy
• Kidney disease

What tests might you need to find the cause?

If you notice blood in your urine, you will need further tests to rule out a sinister cause like cancer. There is no single test that can find the cause in all cases. You may need a range of investigations including:

Urine tests

• Urine tests can detect the presence of an infection or inflammation.
• Urine cytology looks at your urine under a microscope to detect cancer cells.

Radiology (imaging)

• An ultrasound or CT scan can detect kidney stones and cancers of the urinary tract.

Cystoscopy

• A cystoscopy is a procedure where a small camera is passed into the bladder via the urethra (waterpipe). It allows your surgeon to closely examine the lining of your bladder and urethra. It can detect small cancers not seen with radiology imaging.
• Cystoscopy is usually performed as a day case and can be done under a local or general anaesthetic.