Print this topic

HealthInfo Canterbury

Blood in the urine (haematuria)

Important

If you think you have blood in your urine, go to see your GP.

urine-test.jpgBlood in the urine is called haematuria. It's often a symptom of something and not a condition on its own.

When there's lots of blood in the urine you can see this with the naked eye as it looks red or pink. Very small amounts of blood in the urine can't been seen. But it can be picked up when a urine test is done under a microscope or using a urine dipstick.

Not all red or dark looking urine means blood is present. Sometimes it may be due to eating certain foods such as beetroot, rhubarb, blackberries, or taking some drugs such as rifampin. Extreme exercise can also cause muscle breakdown, which can cause kidney damage and change the colour of urine.

Common causes

Often the cause is not found, but testing is needed to rule out important causes.

The most common causes are a bladder infection (UTI) or a kidney infection (pyelonephritis).

Other causes include:

What tests will I need?

Your GP will examine you and ask you questions about your general health and about the blood in your urine.

The first test you will need is a urine test to check for the presence of blood or an infection. Some people may need to have this test more than once.

If you don't have a urine infection and continue to have blood in your urine you will need further tests. These depend on your age and if the blood is visible to the naked eye or only visible under a microscope.

These tests include:

If you're under 40, or over 85, you'll need an ultrasound. This will check for stones or anything unusual in your urinary tract.

If you're between 40 and 85, and have had visible blood in your urine your GP will arrange a CT scan of your urinary tract. This is an X-ray test using dye to look at how your urinary tract is working and to look for anything unusual. If you've had blood in your urine that's only visible under a microscope, your GP will arrange for an ultrasound test.

What happens next?

If you have a urine infection, the first step is for your doctor to treat it before retesting your urine to see if the blood has gone.

Your GP will consider all your information and test results. Sometimes it is not possible to say the exact cause of blood in the urine. If your tests are all normal, your GP will reassure you and arrange any monitoring or GP follow up if needed. If any of the tests are positive or suggest further assessment is needed, they'll refer you to a urologist for specialist assessment.

At the urology department you may need to have a cystoscopy to identify and sample any problems in your bladder. In this test, a special type of thin telescope is inserted through your urethra (the tube you pass urine through) and into your bladder. The urologists may also recommend a urine cytology test to look at the cells under a microscope.

If no cause is found, the specialist may recommend that you and your GP continue to monitor your urine and blood pressure. Sometimes monitoring is all that's needed, sometimes tests need to be repeated, or your GP could refer you back to the urology department.

Written by HealthInfo clinical advisers. Endorsed by clinical director, Urology, Canterbury DHB. Last reviewed February 2018.

Sources

Page reference: 265812

Review key: HIBIU-265812