Haematuria is a medical term given to the presence of blood in a person’s urine. Blood in your urine can come from anywhere in your urinary tract – the bladder, kidneys, or urethra (the tube through which urine exits the body).
If you have blood in your urine, it could be a sign of an underlying health condition and should always be investigated. While haematuria is often not serious, in some cases the presence of blood can indicate an infection, kidney- or bladder stones, or kidney-, prostate-, or bladder cancer.
What Causes Haematuria?
There are many things can cause blood in your urine, including bladder infections, kidney stones and kidney disease.
Possible causes of blood in urine include:
- Urinary tract infection (UTI): UTIs can cause a burning pain when urinating, the need to pass urine often, smelly or cloudy urine, a high temperature or pain in sides or lower back.
- Pyelonephritis: Pyelonephritis is an infection that has reached your kidneys.
- Cystitis: An inflamed bladder, which can be caused by infection or an inflammatory condition such as interstitial cystitis.
- Kidney stones: Kidney stones produce very painful symptoms, including severe pain in your sides, lower back or groin that comes and goes. You may also feel sick.
- Enlarged prostate: An enlarged prostate is common in men over 50. It can make it difficult to urinate, can cause the feeling of needing to urinate urgently or wake you up at night to use the toilet.
- Bladder cancer: Bladder cancer is most common in men, smokers, and older people.
- Kidney cancer: Kidney cancer is most common in men, diabetics, people with a family history of cancer, smokers, and those with obesity.
- Menstruation: You may see blood in your urine when you are menstruating.
- Endometriosis: Endometriosis causes fragments of the inner lining of the uterus to grow elsewhere in the pelvic cavity.
- Sickle cell disease: People with sickle cell disease have abnormal haemoglobin which causes the red blood cells to become hard and sticky and look like a ‘sickle’.
Signs And Symptoms Of Haematuria
Blood in your urine can either be macroscopic or microscopic. You will notice macroscopic blood when you urinate, giving your urine a pink or red colour. Microscopic blood is only detectable using urine test sticks or when a urine sample is sent off to the lab for analysis.
Although blood in your urine does not always point to an infection or disease, it may be an important warning sign to a possible health problem. You should contact your doctor as soon as possible if you suspect that you have blood in your urine or if you have any symptoms associated with haematuria, including:
- Frequent, painful or urgent urination
- Nausea and/or vomiting
- Fevers and/or chills
- Pain in your back or lower abdomen
How is Haematuria Diagnosed?
Initially, your doctor will gather your medical history and conduct a physical examination, which might involve a pelvic exam for women or a digital rectal exam for men. Your doctor might also recommend additional diagnostic tests, including urinalysis to detect various conditions such as urinary tract infections, kidney disease, and diabetes.
A urine culture can be performed to identify infections, while urine cytology examines for abnormal cells or signs of cancer. Procedures like cystoscopy allow visualisation of the bladder and urethra using a cystoscope, for a more in-depth assessment.
Your doctor might also suggest tests like an ultrasound, computed tomography (CT) scans and magnetic resonance imaging (MRI) scans to provide detailed images of your abdomen, pelvis, and other internal organs..
How Is Haematuria Treated?
Treating haematuria will ultimately depend on what the cause is for the blood in your urine. Your doctor or urologist will decide on the best treatment based on the results of your diagnostic tests.
Options for treatment include antibiotics for infections, alpha-blockers for enlarged prostate, tailored approaches for cancer, disease-modifying agents for sickle cell disease, various medications for kidney issues, and hormone-related treatments for endometriosis.
Can Haematuria Be Prevented?
As with treatment, prevention of haematuria depends on the underlying cause. People who are most likely to have haematuria are those with existing diseases such as infections of the urinary system, urological anatomical abnormalities, family histories of urologic diseases and certain genetic conditions. You may also be more at risk if you take certain types of medications, such as blood thinners and some types of pain relievers.
You may be able to decrease your risk of having haematuria by avoiding certain behaviours:
- Overusing pain medications
- Excessive exercise
- Occupational risks (metals, fumes, dyes, rubbers)
- Vigorous sexual activity
- Staying adequately hydrated
Frequently Asked Questions
A urinary tract infection (UTI) is an infection in any part of the urinary system which includes the kidneys, ureters, bladder, and urethra. Infections of the lower urinary tract - the bladder and the urethra – are most common.
No, haematuria is when you have blood in your urine while dysuria is when you have pain or discomfort when urinating.
A urologist is a doctor who has specialised in the urinary system. A urologist also treats conditions involving the male sex organs and male sexual dysfunction. All urologists are trained as surgeons.