Blood in Urine (Haematuria)

 

Overview

There are two different types of haematuria:

 

• Visible haematuria: the urine looks pink, red or brown. It is important to know that certain antibiotics such as rifampicin or nitrofurantoin and food like beetroot can turn the urine pink or red, mimicking blood in the urine. If you see blood in the urine, even if once, then you should be investigated promptly by a urologist, as approximately half of people with visible haematuria do have an underlying urological condition including cancer.

 

• Non-visible haematuria: the urine colour is normal. There is a small amount of blood in the urine which cannot be seen, but detected by a dipstick or seen under microscope. Around 1 in 10 people with non-visible haematuria will have a cause identified. If you have non-visible haematuria and you are over the age of 40, with urinary symptoms or pain, then you will require a referral to a urologist for investigations.

   

   

Causes of haematuria

There are many causes of haematuria including:

 

• Urinary tract infection (cystitis).

 

• Stones in the  kidney or the bladder.

 

• Cancers of the kidney or the bladder.

 

• Benign Prostatic Hyperplasia (BPH).

 

• Inflammation of the kidney (nephritis).

 

• Injury to the urinary tract.

 

• Blood disorders : sickle cell disease and clotting disorders.

 

• Certain medications: cyclophosphamide, anticoagulant and anti-platelet drugs.

 

• Strenuous exercise.

 

• Rare infections: TB and Schistosomiasis.

   

   

Assessment of haematuria

This includes a full medical history, physical examination and tests including:

 

• Urine test.

 

• Blood test.

 

• Scan (ultrasound or CT).

 

• Flexible cystoscopy.