Haematuria: Causes, symptoms and prevention

In his latest online article, consultant urological surgeon Mr Haider Syed delves into haematuria. He answers his patients most frequently asked questions regarding this condition, including the symptoms and treatment options.
 

What is haematuria?

The presence of visible blood in the urine is known as haematuria. Blood can originate from the kidneys (where urine is produced) or any other part of the urinary tract. The urinary tract includes the ureters (the tubes that connect each kidney to the bladder), the bladder, the prostate (in men), and the urethra.

Typically, haematuria is not dangerous. However, it is important to determine the cause, as it can sometimes be due to a serious condition or bladder cancer.

Is blood always visible in urine?

Haematuria is categorised into two types:

• Macroscopic haematuria: the blood is visible, colouring the urine pink, red, or brown. If you notice blood in your urine, you should consult a doctor immediately.
• Microscopic haematuria: the urine appears normal in colour, but red blood cells are detected under a microscope. This is usually identified during a routine urine test.

What are the signs and symptoms of haematuria?

As mentioned earlier, macroscopic haematuria causes urine to change colour due to the presence of red blood cells. Even a small number of red blood cells can turn urine crimson, and this bleeding is usually painless. However, the passage of blood clots in the urine can be uncomfortable. Generally, there are no other signs or symptoms associated with haematuria.

What are the causes of haematuria?

The most common causes of haematuria identified by health professionals include:

• A bladder or urinary tract infection, which causes a burning sensation or pain during urination
• A kidney infection
• Certain kidney conditions or diseases that form kidney stones, often causing pain in the back or sides
• Excessive physical exertion or injury
• Enlarged prostate, which can lead to the development of cancer in the bladder, prostate, or kidney

Although short episodes of dehydration cannot directly cause haematuria, chronic dehydration can damage the kidneys and eventually lead to urinary bleeding by aggravating underlying urinary disorders, such as infections.

Is haematuria a dangerous condition?

In many cases, the presence of blood in the urine is due to a non-serious condition that can be diagnosed and treated after consulting a specialist. However, it is crucial to rule out more serious illnesses such as bladder, prostate, and kidney cancer.

How is haematuria identified?

Several tests may be conducted to determine the cause of blood in the urine:

• Urine tests can provide information about the composition of the urine and the health of certain cells in the bladder and kidney lining.
• Blood tests can indicate signs of kidney or other diseases.
• CT scans can reveal abnormalities in the kidneys, bladder, and ureters, as well as kidney stones.
• Cystoscopy is a procedure that allows a specialist to view the bladder using a camera inserted into the bladder.
• A kidney biopsy involves removing a small sample of kidney tissue for examination under a microscope for signs of disease.

Can haematuria be prevented?

Haematuria cannot always be prevented. However, by taking the following precautions, the risk of developing some of the underlying conditions that can cause haematuria can be reduced:

• Urinary tract infections: drink plenty of fluids, urinate frequently, and for women, wipe from front to back.
• Kidney stones: drink plenty of fluids and limit your intake of salt and protein.
• Bladder cancer: drink plenty of fluids, stop smoking, and avoid chemical exposure.
• Kidney cancer: avoid smoking, maintain a healthy body weight, and follow a healthy diet.

What is the treatment for haematuria?

The best treatment for haematuria depends on its cause. Treatment may begin with a blood test and can include antibiotics to treat a urinary tract infection, medications to reduce the size of an enlarged prostate, or shockwave therapy to dissolve stones in the kidney or bladder.

A follow-up visit is typically necessary to ensure there is no longer blood in the urine and that the underlying cause of the bleeding has been effectively treated. In some cases, no medication is needed, and patients can alleviate their symptoms by resting and drinking plenty of fluids.

Blood in urine (haematuria) in females: Causes, diagnosis, and treatment

According to the National Institute of Diabetes and Digestive and Kidney Diseases, stones in the urinary tract can cause pink, red, or brown urine, frequent urination, incontinence, painful urination, and cloudy or foul-smelling urine.

The Urology Care Foundation lists dehydration, excessive salt intake, gastrointestinal issues (such as Crohn’s disease or ulcerative colitis), thyroid abnormalities, and obesity as potential factors that increase the risk.

Bladder cancer signs and symptoms

Even if the urine appears normal, a urinalysis may detect trace amounts of blood due to accompanying symptoms or during a general health screening.

Mr Haider Syed is a consultant urological surgeon based in Birmingham with more than 30 years of experience. If you would like to book a consultation with Mr Syed, you can do so today via his Top Doctors profile.