Blood in the urine: what does it mean?

Written by: Mr Jeremy Crew
Published: | Updated: 06/05/2019
Edited by: Cal Murphy

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:

Learn what causes haematuria in children

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.

By Mr Jeremy Crew

Mr Jeremy Crew is a consultant urological surgeon with 22 years of urological clinical practice. With private practices in Oxford and Banbury, Mr Crew offers state-of-the-art management for bladder, prostate and renal cancer, urinary tract infection (UTI), benign prostate enlargementvasectomy, and vasectomy reversal.

Mr Crew has been performing vasectomies for over 20 years and vasectomy reversal for over 13 years, with a high level of success and patient satisfaction for all of his procedures. For benign prostate enlargement he offers a relatively new procedure known as Holmium Laser Enucleation of the Prostate (HoLEP), which has the advantages of reduced bleeding and a shorter hospital stay compared to traditional prostatic surgery.

After qualifying from Cambridge University and St Thomas' Hospital, London, Mr Crew undertook basic surgical training in London and Guildford prior to starting specialist urological training in Oxford in 1994. In 1998 he received the European Association of Urology Thesis Award and the Sir Walter Langdon Browne Award for his thesis on the molecular biology of bladder cancer. He went on to pursue additional training in urooncology with travelling fellowships to the Memorial Sloan-Kettering Cancer Centre, New York, and Inselspital Hospital, Bern. Mr Crew is now urological lead at Churchill Hospital, Oxford, and sits on the British Association of Urological Surgeons (BAUS) Section of Oncology Committee.

In additon to teaching students and junior doctors at the University of Oxford, Mr Crew maintains an active interest in research and clinical trials, and has produced over 40 publications in books and peer reviewed journals. With his extensive experience, outstanding academic record, and access to highly specialised equipment within Oxford, Mr Crew offers a full, evidence-based, and individualised urological service to private patients.

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