Haematuria

Haematuria is a common condition and one which must be taken seriously. Haematuria simply means blood in urine. Haematuria is usually divided into macroscopic (where the urine is discoloured) and microscopic (where the blood is found only on dipstick or microscopy examination). If you notice blood in the urine it should always be investigated, although in most cases no serious cause will be found.

Points to consider about Haematuria (Blood in urine)

• Haematuria may not always be a bad thing,
• Haematuria can be detected in the urine during a menstrual period.
• It can occur only during a urine infection.
• Sometimes some medicines and foods can colour the urine red. This is not the same as passing blood.
• It can occur following strenuous physical exercise.
• It is often more likely to occur when you take anti-platelet (aspirin, plavix) and anti-coagulant (warfarin, clexane) medications.

Haematuria can originate from the kidney itself due to inflammation in the kidney, eg glomerulonephritis affecting the filtering units (glomeruli). When this is the cause of haematuria there are often other signs of kidney disease such as high blood pressure presence of protein in urine, or abnormal renal function.

Kidney cysts, tumours or kidney stones can also cause haematuria. Blockages, stones and tumors in the ureter and bladder may cause haematuria. The bladder may also be the cause of haematuria, in cystitis (bladder infection), stones, or tumours in the bladder. Diseases of the prostate gland such as prostatitis or prostate cancer may also cause haematuria.

Rarer causes of haematuria include vascular malformations and atypical infections (tuberculosis). 

What next

It is important that you present to your family doctor if you have haematuria. Routine blood tests, urine microscopy and cytology as well as imaging such as renal tract U/S or CT urogram should be organised. A cystoscopy (telescopic examination of bladder and urethra) is usually required to complete the investigation of lower urinary tract abnormality such as bladder cancer.