What is haematuria?
Haematuria refers to blood in your urine. It may be visible, that is, you can see the urine looking red or microscopic or it may be visible only under a microscope. It can cause considerable anxiety and should be investigated. Causes may be benign or may include more ominous problems.
What are the symptoms?
“The urine may appear pink or red or look like coca cola. There may or may not be pain depending on the cause. Although certain foods and even exercise may cause the urine to appear bloodstained, my suggestion to you would be that you consult your doctor if there is any suspicion of blood in your urine.
How is it diagnosed?
Visible blood is readily apparent. Microscopic bleeding is typically found on dipstick testing of the urine – you may notice the doctor or nurse placing a tiny stick into the urine. However, haematuria should be confirmed by microscopic examination of the urine where the technologist will confirm that red blood cells are actually present.
What causes haematuria?
This list is long. Infection or inflammation of the kidneys, stones, an enlarged prostate, inherited conditions, certain drugs or even exercise may cause blood to appear in the urine. The most worrisome cause of haematuria is cancer. Cancers may affect any genitourinary tract organ and may cause haematuria. Cancers are particularly a concern in older male patients and among those who smoke, but may occur in anyone.
What further tests should be carried out?
Once haematuria is confirmed your doctor should refer you to a urologist who will request several further tests including basic blood tests and a test of your urine for bacteria to rule out an infection. You will also need imaging tests of your kidneys and urine tracts (ureters). This may be accomplished via ultrasound, MRI or CT scans – a well done CT with contrast (dye injected in the veins) is the investigation of choice.
You will also likely need a cystoscopy where the urologist will use an instrument with a camera to view the inside of the bladder and penis to make sure there are no cancers. It is also important that a thorough physical examination be carried out by the urologist, inclusive of a rectal examination of the prostate depending on your age.
What is the treatment for haematuria?
The treatment of haematuria will depend on the cause. Once a cause is determined, your urologist will discuss your treatment options. If no cause is determined, further tests may be warranted. Particularly in the case of microscopic haematuria in which no cause is found following exhaustive investigation, the urologist will request a periodic urine examination to see if the bleeding comes back.
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