Possible reasons for blood in the urine

Blood may be present in the urine (known as haematuria) due to an infection but it is also important to consider if there could be a more serious cause for the bleeding. It is always recommended that you visit your doctor for a check-up as blood in the urine can also be associated with bladder, kidney or prostate problems.

We’ve asked one of our highly-experienced consultant urologists Mr Aidan Noon just how serious blood in the urine can be, the possible causes and when to see a specialist.
 

What does blood in the urine usually mean?

It is important to understand the different ways in which blood can be detected in urine as this will alter the recommendations made by doctors. If blood has been seen in the urine by the patient then the medical term for this is visible haematuria.

Blood can also be detected in the urine even if it can’t be seen by the eye, which is called non-visible haematuria. Non-visible haematuria may be detected by urinary dipstick testing of a urine sample or by analysis in a laboratory.

If blood is detected in the urine it means that there is a risk of an underlying problem with the urinary system (from kidneys to the end of the water pipe). There are many causes of blood in the urine but our current guidelines make recommendations for tests to check for any serious underlying problems such as cancer.

Sometimes the cause of bleeding is due to a stone, infection or inflammation. After testing the patient, sometimes no underlying cause for blood in the urine can found but importantly patients will have been carefully checked to make sure there is no serious problem.
 

Can blood in the urine be a sign of a UTI or STD?

If you are concerned that you may have a sexually transmitted disease (STD) you should get checked by your GP or at a Genito-Urinary Medicine (GUM) clinic.

Urinary tract infections in male patients will often require investigation to ensure there is no underlying cause for them. Persistent infections or symptoms of infection (dysuria) should also be investigated, especially in patients over 60 years of age.
 

Is blood in the urine dangerous?

If there is a large amount of blood in the urine causing blood clots to form (more likely if a patient is also taking medication to thin the blood) then occasionally the bladder will not easily empty and a condition called urinary retention can develop.

This normally will require attendance at an Accident and Emergency department for a catheter (tube) to be inserted to help the catheter drain. The presence of blood in the urine is not normally dangerous in itself but may indicate that there could be a serious underlying cause. Again, it is important that blood in the urine is discussed with a doctor to decide if further investigations are necessary.
 

How should blood in the urine be treated?

It is better to consider how blood in the urine should be investigated, for example, by looking at what has caused it and if there is an underlying problem that needs treatment. In most cases, this will involve tests under the care of a urologist.
 

How is blood in the urine investigated?

The bladder will be inspected by a special camera (flexible cystoscopy) to look to see if there is anything abnormal with the bladder or water pipe. Flexible cystoscopy is a quick procedure usually carried out in an outpatient setting, which looks for any causes of blood coming from upstream of the bladder and then a radiological test will be recommended.

The radiological test may be an ultrasound scan or a CT scan. The decision on which test will often depend on the patient’s medical history and whether there is visible or non-visible haematuria.

If these urological investigations are normal then sometimes patients will be advised to see a nephrologist (a doctor who specialises in renal medicine) to see if blood may be leaking directly into the urine from the kidney.

A kidney cause of the blood in the urine is more likely with associated conditions such as hypertension (high blood pressure), protein in the urine (proteinuria) and abnormal kidney function.
 

Does blood in the urine always require treatment or can it go away on its own?

Blood seen in the urine by a patient will always need to be discussed with a doctor. A doctor should decide if further tests are required as it is important that an underlying cause for the bleeding is not missed. Patients do not require treatment because blood is present in the urine but may require treatment for the underlying cause.


If you’re worried about blood appearing in your urine, do not hesitate to book an appointment with Mr Noon via his Top Doctor’s profile now, for an expert medical opinion.