Haematuria

What is Haematuria?

Haematuria is the medical term for blood in the urine. Various conditions, including kidney or bladder infections, kidney stones, or certain types of cancer, can cause it. 

Symptoms can include pain or discomfort while urinating, frequent urination or difficulty urinating. Treatment will depend on the underlying cause of the haematuria.

How Does Haematuria Impact Your Anatomy and Health?

In general, blood in the urine can indicate an underlying problem with the urinary tract, such as the kidneys, bladder, ureters, or urethra.

Some of the possible impacts of haematuria include:

  • Kidney damage or disease: Haematuria can signify kidney diseases, such as glomerulonephritis or a kidney infection. In these cases, the blood in the urine may result from damage to the small blood vessels in the kidneys.
  • Bladder or urinary tract infections: Haematuria can also be a symptom of a bladder or urinary tract infection, which can cause inflammation and irritation in the urinary tract.
  • Kidney stones: The presence of blood in the urine can also be a sign of kidney stones, which can cause damage to the urinary tract as they pass through.
  • Cancer: Haematuria can be a symptom of certain types of cancer, such as bladder or kidney cancer. In these cases, the blood in the urine may result from a tumour or other growth in the urinary tract.

Types of Haematuria

Haematuria can be classified into two main types: gross (visible to the naked eye) and microscopic (only visible under a microscope).

  • Gross haematuria: This type of haematuria is characterised by visible blood in the urine. The urine may be pink, red, or brown. This type of haematuria is usually easy to detect and can be caused by various conditions, including kidney stones, urinary tract infections, and bladder or kidney cancer.
  • Microscopic haematuria: This type of haematuria is characterised by blood in the urine that is only visible under a microscope. The urine may appear normal to the naked eye, but a urine test will reveal the presence of red blood cells. Various conditions, including kidney disease, urinary tract infections, and certain types of cancer, can cause this type of haematuria.

Who is Affected by Haematuria?

Haematuria can occur in people of all ages, genders and races. However, certain groups may be at an increased risk of developing the condition. These include:

  • Men: Men have a slightly higher risk of developing haematuria than women, particularly as they get older. This may be due to an increased risk of prostate cancer in men.
  • Individuals with a family history of kidney disease: If a person has a family history of kidney disease, they may be at an increased risk of developing haematuria.
  • Individuals with a history of kidney stones: People with kidney stones in the past may be at an increased risk of developing haematuria.
  • Individuals with a history of bladder or kidney cancer: People who have had bladder or kidney cancer in the past may be at an increased risk of developing haematuria.
  • Individuals with chronic diseases: People with certain chronic conditions, such as diabetes or high blood pressure, may be at an increased risk of developing haematuria.
  • Athletes: People who engage in high-impact sports or heavy lifting may be at an increased risk of developing haematuria due to the increased risk of trauma to the urinary tract.

Common Causes of Haematuria

Haematuria can have several causes, including:

  • Urination problems such as voiding dysfunction, overactive bladder, and nocturia
  • Urinary tract infections (UTIs)
  • Kidney or bladder stones
  • Prostate problems in men
  • Certain medications
  • Certain cancers, such as bladder or kidney cancer
  • Trauma to the urinary tract
  • Certain genetic disorders, such as sickle cell anaemia

Consult your doctor if you experience haematuria, as it can be a symptom of a severe underlying condition.

Symptoms of Haematuria

The main symptom of haematuria is blood in the urine. Other symptoms may include:

  • Pain or discomfort while urinating
  • Frequent urination
  • Difficulty urinating
  • Cloudy or strong-smelling urine
  • Lower back or abdominal pain
  • Fatigue
  • Anaemia (low red blood cell count)

It's worth noting that some of these symptoms may be caused by an underlying condition that is causing haematuria. For example, suppose a urinary tract infection is causing haematuria. In that case, the individual may also experience a frequent need to urinate, burning or pain while urinating, and cloudy or strong-smelling urine.

Remember that some people may not have any symptoms at all, so it's essential to have regular check-ups and urine tests to detect haematuria early.

If you are experiencing any of these symptoms or have blood in your urine, you should see a urologist as soon as possible. A proper diagnosis is necessary to understand the underlying cause and to start appropriate treatment.

Diagnosis of Haematuria

Haematuria is typically diagnosed through physical examination, urine tests, and imaging studies. The specific diagnostic tests used will depend on the underlying cause of the haematuria and the patient's medical history.

Here are some standard diagnostic methods for haematuria:

  • Urine tests: Urine tests are usually the first step in diagnosing haematuria. A urine sample will be collected and examined for red blood cells. The test may also include a urinalysis, which can detect other abnormalities in the urine, such as protein, white blood cells, or bacteria.
  • Imaging studies: Imaging studies such as ultrasound, CT scan, or MRI may be used to evaluate the urinary tract and detect any abnormalities causing the haematuria. These imaging studies can also see any underlying condition that can cause haematuria, such as tumours or kidney stones.
  • Cystoscopy is a procedure in which a thin tube with a camera on its end is inserted through the urethra and into the bladder to examine the inside of the bladder and urethra.
  • Biopsy: In some cases, a small piece of tissue may be taken from the urinary tract and examined under a microscope to detect cancer or other abnormalities.
  • Blood tests: Blood tests may be done to check for anaemia or other blood disorders causing haematuria.

Treatment for Haematuria

Treatment for haematuria will depend on the underlying cause of the condition.

Here are some standard treatment options for haematuria:

  • Treating the underlying condition: If an underlying condition such as a urinary tract infection, kidney stones, or kidney disease is causing the haematuria, treatment will address that condition. This may include antibiotics for a urinary tract infection, surgery to remove kidney stones, or medication to manage kidney disease.
  • Medications: Medications such as anti-inflammatory drugs or blood thinners may be prescribed to reduce inflammation or prevent blood clots in the urinary tract.
  • Surgery: In some cases, surgery may be necessary to remove a tumour or repair damage to the urinary tract.
  • Monitoring: In some cases, the cause of haematuria is unknown, and further testing and monitoring may be needed to identify the underlying cause.
  • Lifestyle changes: Some changes may be necessary to manage haematuria, such as avoiding certain foods or medications that can cause irritation or inflammation in the urinary tract.

Treatment options may vary from person to person, and your doctor will recommend the best treatment plan based on the underlying cause and your specific needs and health condition.

Some cases of haematuria may resolve independently, and no treatment may be necessary. However, it's still important to consult a healthcare professional to rule out any serious underlying condition.

What is the Significance of Haematuria?

Significant problems in the urinary tract cause not all haematuria.


Studies have shown that even with extensive investigation, a specific cause for the haematuria is not found in up to 70% of patients with microscopic haematuria and up to 50% of patients with macroscopic haematuria.


Haematuria requires investigation to exclude significant or worrying pathology in the urinary tract.


Macroscopic or visible haematuria is more concerning than microscopic (invisible) haematuria. 


Cases of macroscopic haematuria (including even one episode of visible blood in the urine) require thorough investigation because of the significant rate of urinary tract cancers found in people with visible blood in the urine. 


The prevalence of urinary tract cancers in people presenting with the symptom of visible blood in the urine is around 23%. 

What if Haematuria is Untreated?

If haematuria is left untreated, it can lead to several serious complications, depending on the condition's underlying cause. Some of the possible complications of untreated haematuria include:

  • Kidney damage or failure: If haematuria is caused by a condition such as kidney disease or a kidney infection, untreated haematuria can lead to further damage or even failure of the kidneys.
  • Bladder or kidney cancer: If haematuria is caused by bladder or kidney cancer, untreated haematuria can lead to cancer growing and spreading to other parts of the body.
  • Anaemia: Haematuria can lead to a loss of red blood cells, which can cause anaemia (a condition in which there are not enough red blood cells to carry oxygen throughout the body).
  • Chronic kidney disease: If haematuria is caused by chronic kidney disease and left untreated, it can lead to the progression of the disease and end-stage kidney disease.
  • Recurrent infections: Untreated haematuria can lead to recurrent urinary tract infections, which can cause damage to the urinary tract over time.

Some underlying conditions that can cause haematuria, such as cancer, can be life-threatening if left untreated.

It's crucial to visit a urologist if you have haematuria or any other urinary symptoms to understand the underlying cause and start appropriate treatment. Early diagnosis and treatment can help prevent or minimise the risk of these complications.

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