Haematuria: what to know
Blood in the urine, also known as haematuria, is a symptom that may belie a serious issue within the urinary organs and structures, which include the kidneys, ureters, urinary tract, bladder, and urethra. In this article, a consultant urologist explains the possible causes of haematuria, and when patients should seek medical attention.
Ideally, the colour of urine should range from clear to yellow to a pale green; when blood is present from somewhere along the urinary system, urine takes on a pink, red, or brown tone. However, in some cases, traces of blood may not be visible to the naked eye but will register with testing or under microscopic examination.
What is haematuria?
Haematuria is a symptom of a condition, rather than a condition in and of itself. The most common conditions that haematuria is associated with are:
- Urinary tract infections (UTIs)
- Stones in the kidney, bladder, or ureter
- Enlarged prostate
- Cancer of the kidney, bladder, ureter, or prostate
- Urological injury
- Infection and inflammation, such as glomerulonephritis
What causes haematuria?
The causes of haematuria, whilst likely requiring intervention, are mostly not cancerous, but 20 per cent of cases indeed indicate an undiscovered cancer. Patients over the age of 45, smokers, or those with a history of kidney, bladder, or prostate cancer are more at risk of developing cancer themselves. For these patients, it is recommended to undergo regular screening in order to catch cancer in early, easily-treatable stages, and if they find blood in urine, they should not hesitate to seek a diagnostic investigation so that treatment can begin as soon as possible.
Blood can also enter urine due to medications, like blood thinners and antibiotics; patients are encouraged to discuss the side effects of their medications with their doctors.
How is haematuria diagnosed?
The diagnostic process for haematuria involves blood and urine testing to check for infection and kidney function, CT or ultrasound scans of the pelvis and the kidneys, or a cystoscopic examination of the bladder and urethra to look for stones or inflammation.
How is haematuria treated?
The treatment for haematuria will depend on the underlying cause. For non-serious cases, increasing daily intake of water can help to ease or stop the bleeding. If bleeding is profuse, there are clots of tissue or blood when urinating, or there is difficulty in passing urine, then patients should seek medical attention as soon as they can.
Infections can be managed with antibiotic prescriptions. For an enlarged prostate, there are medications and a variety of minimally invasive surgeries available, such as transurethral resection of the prostate and laser ablation to reduce its size and thereby treat haematuria. Some kidney and bladder stones can pass on their own if they are small enough, but surgical treatment or shockwave therapy (ESWL) may be necessary for large stones. Most early cancers are curable with minimally invasive surgical procedures, chemotherapy, and/or radiotherapy.
While haematuria does not always indicate a serious condition, it can be an early warning sign of something that needs treatment. Prompt investigation ensures timely diagnosis and appropriate care, especially in higher-risk individuals.