Haematuria

Haematuria is the medical name for blood in the urine. It can be classified as gross haematuria, which is visible to the naked eye, and microscopic haematuria, which is when red blood cells become visible only under a microscope. Blood in the urine may appear bright red or brown in colour.

It can be alarming to notice blood in your urine and you may assume that this is an indication of a serious medical condition. However, in the majority of cases blood in the urine is not indicative of a serious problem. Many conditions can cause blood to be present in the urine and the majority are not severe - though it is recommended that you get checked out to ensure serious conditions can be either ruled out or treated as early as possible. In many cases the source of haematuria is not known and the individual does not experience any symptoms.

Causes of haematuria

• Cystitis: a bladder infection which is usually characterised by a burning feeling when urinating.
• Kidney stones.
• Enlarged prostate gland.
• Prostate cancer.
• Kidney infection.
• Bladder cancer (this is uncommon in people under the age of 50).
• Kidney cancer (this is uncommon in people under the age of 50).
• Urethritis (when the urethra becomes inflamed).

Diagnosing haematuria

Doctors may carry out several tests to determine the cause of haematuria and these may include:

• Urinalysis
• Blood tests
• Cystoscopic examination
• Intravenous pyelogram

Urinalysis is where a sample of urine is taken and analysed by highly trained technicians to look for white blood cells, which may indicate the presence of an infection, or casts, which are collections of cells that are joined together and may indicate kidney disease. A high level of protein can also indicate kidney disease.

Blood tests are used to analyse samples of blood. A high level of waste products in the blood may indicate kidney disease as the kidneys would normally filter waste products from the blood.

An intravenous pyelogram is an X-ray of the urinary tract. It can identify tumours, kidney or bladder stones, blockage in the urinary tract, or an enlarged prostate gland.

A cystoscopy, which is a long thin tube, is inserted into the urethra and used to take images within the bladder. It is fitted with a tiny camera that transmits images to a monitor in order to detect abnormalities.

Treatment

The treatment chosen will ultimately depend on the cause. If there is no source identified and the patient has no other symptoms or problems, there may be no recommendation of a particular treatment.

Patients will usually be referred to a specialist in the following circumstances:

• There is blood visible in the urine but no pain and tests show no sign of infection.
• The patient is over the age of 40, there is blood in the urine and the patient suffers from recurrent urinary infections.
• The patient is aged over 50 and blood is detected in a urine test.
• A mass which could be a tumour is discovered in the abdomen during a physical examination.