Blood in the urine is commonly known as haematuria. Haematuria most commonly presents in small quantities and is often picked up on a routine screening by a simple dipstick test. Haematuria can also be diagnosed when urine is examined under the microscope (microscopic haematuria) or seen as red or brown discolouration of the urine (macroscopic haematuria).
Blood should not normally appear in the urine. The presence of blood therefore means that there could be a problem in any part of the urinary tract, from the kidneys, ureters, bladder, prostate gland or the urethra.
What is the likelihood the symptoms are serious?
It is rare that patients under the age of 40 years with microscopic haematuria have a serious problem.
In all other cases the presence of haematuria should be investigated.
- 50% of patients with haematuria will have an abnormality
- 10% of patients with microscopic haematuria will have a malignancy
- 35% of patients with macroscopic haematuria will have an underlying tumour
The Haematuria Clinic Service
We have a wide range of specialists in haematuria, urology and urological oncology that can assess the likelihood of disease. A positive dipstick test for blood in isolation can often be distressing and in all cases where symptoms exist, physical examination must also be undertaken and further investigations performed to localise the cause.
All patients should be seen by a specialist urologist:
- A physical examination is required including a prostate examination for men and gynaecological organs in the female.
- Samples of urine must be sent for microscopy and culture [investigation of infection], and urine cytology [investigation of abnormal cells in the urine].
- Arrange a blood test to establish kidney function and signs of infection or clotting abnormality.
- Undertake an ultrasound examination of the renal system including the bladder, and a plain abdominal x-ray.
- Perform a cystoscopy, which is an investigation involving a tube being passed into the bladder.
- In some cases an intravenous urogram (IVU) or a CT scan will be undertaken to visualise the renal system to check for obstruction.
It is important to remember that the job of the specialist is to diagnose early and treat any serious pathology but more commonly to exclude serious pathology and to reassure the patient.
We also have expert radiologists who specialise in imaging of the urinary tract and pelvis and who work closely with their urology colleagues to provide the very best in diagnosis.
We aim to provide you with a fast track service to ensure you are fully informed and to the options available to you.