Haematuria: should I worry about blood in my urine?

Haematuria is the medical term for blood in the urine. What is the main reason for blood in the urine? What can it be a sign of? Expert consultant urologist Mr Liaqat Chowoo, who sees patients in Milton Keynes and Bedford, shares his expertise on the conditions and answers the most commonly asked questions. 

What is haematuria?

Haematuria is, essentially, blood in the urine. The blood can be visible in the urine, it can be tiny clots, or the urine can be pink in colour; these are all classified as blood in the urine. Gross haematuria is when the person can see it. Microscopic haematuria means you don’t see the blood but it can be seen under a microscope, and when a dipstick is put in the urine, it picks up a trace of blood in the urine. 

What are the main symptoms to watch out for?

The main symptoms for patients to watch out for are seeing red urine or small clots in the urine. However, if a patient has symptoms of a lower urinary tract infection, which include the need to frequently and urgently urinate, waking up often at night to pass urine, issues with passing urine, or a weak flow, these might be signs of microscopic haematuria. This will be confirmed by a urine test performed by a clinician.  

What are the known main causes?

Blood in the urine can come from the kidneys, the ureters (kidney tubes), the bladder, the prostate (in men), or the urethra. All along the urinary tract, any type of cancer, stone, inflammation, or infection can lead to haematuria. Common conditions include:

• UTI
• kidney infection or disease
• bladder stone or kidney stone
• prostate enlargement
• bladder, kidney, prostate cancer

There are some other conditions, which aren’t pathological but are physiological, that can lead to haematuria. For some people who exercise vigorously and spend a lot of time in the gym, if their urine is checked there will be a trace of blood in their urine. Following sexual activity, people can also experience some blood in the urine. 

When does it become a medical emergency?

Most people, if they see red blood in their urine, go and see their doctor because there is a general and genuine fear that it might be something serious. However, people may end up in A&E if the blood in the urine is so thick that it beings to clot. This clotting affects the urine flow which may result in urine retention. This is the main emergency that is associated with blood in the urine. If people are passing urine and the urine is pinkish or reddish, it’s generally not a reason to seek immediate, emergency care. It can be managed with further testing. 

Might it be a warning sign of another condition?

Of course, haematuria might be a warning sign of another condition. There are blood conditions like leukaemia, lymphoma, or platelet disorders, which reduce the blood’s clotting capability and can lead to haematuria. Some conditions that lead to haematuria might not even be urological issues. Sometimes, people’s urine can change colour due to the food that they consume, so nutrition may play a role in causing genuine haematuria or a false alarm. I would suggest to anyone who is worried about their waterworks, that they should get tested to find out whether there is blood in the urine or not. 

Treating patients in Milton Keynes and Bedford, Mr Liaqat Chowoo is a renowned consultant urologist. If you would like to book a consultation with him, you can do so by visiting his Top Doctors profile today.