Haematuria

Condition

It's more than a medical observation - it's an alarming signal that calls for immediate and careful evaluation. This condition can be a sign of multiple underlying health issues, making it an important indicator that we cannot afford to overlook. Bladder cancer, urolithiasis, infections, benign prostatic enlargement, prostate cancer and renal conditions - these are some of the most common culprits behind haematuria. Each carries its own implications, making it crucial to identify the exact cause for effective treatment. The path to diagnosis isn't a single route, but a combination of flexible cystoscopy and CT urography. Together, these diagnostic methods allow us to get a detailed picture of what's going on inside the body, providing the information needed for an accurate diagnosis.

Treatment

When it comes to management, a one-size-fits-all approach simply won't do. Treatment is tailored to the underlying condition, ensuring that we're not just addressing the symptom, but also targeting the root cause. In the face of haematuria, we're not just treating a symptom - we're committing to a comprehensive diagnostic and treatment strategy to resolve the underlying issue and restore health.

F.A.Q.s

What is hematuria?

Blood in your urine is called hematuria. The amount can be from very small and only detected with urine tests or under a microscope to visible when it turns the toilet water red or pink.Sometimes the patient may see spots of blood in the water after urinating.In any case hematuria is an alarming sign that should not be overlooked and there should be no delay in seeking Urological advice.

What could have caused the blood in the urine?

About half of patients with visible blood in the urine will have an underlying cause identified but, with non-visible blood( this detected only under the microscope) in the urine, only 10% will have an identifiable cause.

Although there are many potential causes for blood in the urine, those most often identified are:

bladder infection
cancers of the bladder, kidney or prostate
benign enlargement of the prostate
stones in the kidneys or bladder
inflammation of the kidneys
urinary tract injuries
blood disorders (e.g. sickle cell disease, clotting disorders, anticoagulant and anti-platelet drugs)

Is there anything else,apart from blood that can turn urine into red?

Red or pink urine is not always a sign of bleeding from the kidneys,bladder,prostate etc.

There are a few conditions that may look like blood in the urine but they aren’t.Some of those are:

recent consumption of beetroot
a new medicine ,some medicines can turn pee red or brown
bleeding from the bowel or anus
during period
a condition called jaundice
severe dehydration

In any case even the suspicion of blood in the urine is a reason why someone should seek medical advice to rule out significant or even life threatening conditions.

Is there any chance, following a long run or contact sports to see blood in the urine?

Yes, some people following activities that involve contact or after long runs can see blood in their urine but this is a benign condition. This is quite common among marathon runners ,the so called “marathoner’s hematuria” or “runner’s bladder”.

This condition usually persists for 2-3 days and does not need any investigations, unless it continues for more than 3 days, in which case the patient should seek Urological advice.

What test does someone need to identify the underlying cause of haematuria?

As in any medical condition a detailed history is mandatory.Your doctor may also ask you to do some blood tests to check your kidney function,PSA,haematocrit etc and rule out other conditions such as coagulation disorders.

Following that,there three main tests necessary to identify the cause of hematuria:

CT scan
Urine cytology , an examination to detect cancer cells in urine
Flexible cystoscopy, an examination that uses a thin flexible camera to inspect the bladder.

In rare cases where conditions of the kidneys or ureters cannot be ruled from the initial investigations the patient may need to undergo diagnostic ureteroscopy to directly inspect the upper urinary tract.

If my investigations are negative but I still have blood in my urine,do I need any treatment for that?

No,this is the so called idiopathic hematuria that does not need any treatment.Actually in most people with negative investigations,hematuria will stop after a certain amount of time but there will be some which it won’t.In those cases periodic evaluation is advised to be sure that it is not a sign of a more serious problem.