What is Haematuria?

Haematuria means blood in the urine. It may be visible to the naked eye (visible haematuria) or detected only on a urine test (microscopic or non-visible haematuria).

Blood in the urine can occur for many reasons. Some causes are harmless, while others may require further medical investigation.

Because haematuria can sometimes be a sign of serious underlying conditions, it is important that it is properly evaluated.

Investigation of Haematuria

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Possible Causes of Haematuria

Urinary Tract Infection (UTI)

Infection of the bladder or kidneys may cause blood in the urine.

Symptoms may include:

  • Burning when urinating

  • Frequent urination

  • Lower abdominal pain

  • Fever

Kidney or Bladder Stones

Stones in the urinary tract can irritate the lining of the urinary system and cause bleeding.

Symptoms may include:

  • Severe flank or abdominal pain

  • Pain when urinating

  • Nausea or vomiting

Enlarged Prostate (Benign Prostatic Hyperplasia)

In men, an enlarged prostate may lead to bleeding from the prostate or bladder.

Symptoms may include:

  • Difficulty starting urination

  • Weak urinary stream

  • Frequent urination, especially at night

Kidney Disease

Certain kidney conditions may cause microscopic haematuria detected on urine tests.

Tumours of the Urinary Tract

In some cases, haematuria may be caused by cancers involving the:

  • Bladder

  • Kidney

  • Ureter

  • Prostate

This is why investigation is important, particularly in older patients or those with risk factors.

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Why Investigation is Important

Investigating haematuria helps doctors determine the cause of bleeding and rule out serious conditions such as urinary tract cancers.

Even if bleeding stops, further tests may still be required.

Tests Used to Investigate Haematuria

Your doctor may recommend several tests

Urine Tests

Urinalysis

A urine sample is examined to detect:

  • Blood

  • Infection

  • Protein or abnormal cells

Urine Culture

This test checks for bacterial infection.

Urine Cytology

Urine may be examined for abnormal or cancerous cells.

Blood Tests

Blood tests may be performed to assess:

  • Kidney function

  • Signs of infection

  • Other medical conditions

Ultrasound

Ultrasound uses sound waves to examine the kidneys and bladder.

It may be used as an initial imaging test, especially in younger patients.

Cystoscopy

Cystoscopy is a procedure that allows the doctor to look directly inside the bladder and urethra.

During this procedure:

  • A small camera (cystoscope) is passed through the urethra into the bladder.

  • The bladder lining is carefully examined.

Cystoscopy is particularly important for detecting bladder cancer or other abnormalities.

The procedure is usually performed under local anaesthetic and takes about 10–15 minutes.

What Happens After Investigation?

Once all tests are completed, your doctor will discuss the findings and recommend appropriate management.

Possible outcomes include:

  • Treatment of infection or stones

  • Monitoring with repeat testing

  • Referral for further treatment if abnormalities are detected

In many patients, no serious cause is found.

When to Seek Urgent Medical Attention

Seek immediate medical care if you experience:

  • Large amounts of blood in the urine

  • Blood clots in the urine

  • Severe pain in the back or abdomen

  • Difficulty passing urine

  • Fever or chills