Blood in the urine: what does it mean?

It can come as a nasty surprise when you go to the toilet and find that your urine is coming out a red or pink colour. Whilst some food such as beets or rhubarb can turn the urine red this cannot be assumed and red or pink urine is probably haematuria – in other words, blood. Expert urologist Mr Jeremy Crew is here to explain what causes visible blood in the urine.

What is haematuria?

Haematuria is the presence of blood in the urine, and with visible haematuria, you can actually see the blood. It does not take much blood to turn the urine pinkish. Around about a quarter of a teaspoon of blood will turn a pint of urine into an obvious pinkish-red colour.

I want to be very clear that we are speaking about visible haematuria. This is not to be confused with non-visible haematuria, which is picked up by dipstick testing.

Why do I have blood in my urine?

A small amount of blood in the urine may not indicate a significant problem as it can be related to transient and lifestyle causes, such as medication, exercise, or sometimes a mild infection.

However, all cases of visible blood in the urine require investigation to exclude significant, progressive causes. Some of these causes may be:

• Bladder cancer
• Renal cancer
• Kidney or bladder stones
• Kidney or bladder infections
• Inflammatory conditions of the kidney

Is having haematuria dangerous?

Haematuria itself is not dangerous, but it certainly requires investigation, as the causes of visible haematuria may be dangerous.

Is there a treatment for haematuria?

The treatment for visible haematuria is really more the treatment of the underlying cause. A patient must have an investigation and testing to exclude a significant cause that needs treatment.

In my experience, the majority of patients will have one of the following outcomes:

1. A cause for the haematuria is found and treatment is initiated immediately.
2. No underlying cause is found, but the haematuria settles of its own accord, without treatment.
3. No cause is found, but the haematuria persists or recurs.

The final group is very rare and usually will require a more in-depth consideration and examination as to what the underlying cause is, with more sophisticated investigations including renal angiograms.

If you have noticed blood in your urine, visit Mr Crew’s Top Doctors profile to book a consultation.