Haematuria means the presence of blood in your urine. If you notice blood in your urine, even if it has only happened once, you must have it investigated. The most common cause is due to an infection (cystitis) but it may be a sign of bladder cancer, stones in the kidneys or bladder, inflammation of the kidneys (nephritis), urinary tract injuries, blood disorders (such as sickle cell disease) and less common infections (such as TB). 30% of patients with visible haematuria will have an underlying cause identified, however, with non-visible blood in the urine only approx 5% will have a cause identified.
Symptoms
Haematuria in your urine may appear as a bright pink, red or dark brown colour, if it is visible. Other symptoms that accompany this can be indicative of the cause. For example, a burning pain when urinating, urgency to urinate, smelly urine, a high temperature and pain in your sides or lower back may indicate a urinary tract infection (UTI). If you experience pain in your sides, lower back or groin that comes and goes and you feel nauseous, this suggests you could have kidney stones.
The appearance of blood in your urine may in fact be something else. It may not be blood in your urine if:
- You are taking a new medication. Some medicines can turn urine red or brown.
- You have recently eaten beetroot as this can turn your urine pink.
- If it is happening during your period.
- If you are bleeding from your bottom instead.
Diagnosis and treatment
To diagnose haematuria, your consultant will ask you about your past medical history and the symptoms you have been experiencing. A urine test called a urinalysis will be performed initially to check for an infection. If the cause of haematuria is an infection this can be treated with a course of antibiotics.
If there are no signs of an infection, some or all of the following assessments will be performed:
- A physical examination (including rectal or vaginal examination)
- Examination of your urine for cancerous cells
- Ultrasound scan
- CT scan (may involve an iodine-based injection)
- Flexible cystoscopy
If an abnormality is detected, your treatment will depend on the reason for haematuria appearing in your urine. If no specific abnormalities are found and no treatment is required, it is important that you report any further bleeding or symptoms to your consultant.