Haematuria is blood in the urine. There are two types of haematuria, gross haematuria and microscopic haematuria. Gross haematuria occurs when you can see blood in your urine. Microscopic haematuria occurs when the blood is not visible to your eye but can be seen under a microscope or in an analysis of urine in a lab. Often, haematuria is not an indication of serious illness, but sometimes it is. That’s why it’s important to see a doctor if you have blood in your urine.
Haematuria is considered one of the most common reasons that people see a urologist (a doctor that specialises in the urinary tract), with gross haematuria being less common than microscopic haematuria.
The main symptom of gross haematuria is a change in the colour of urine. Usually, urine will change from the normal clear or yellow colour to pink, red, or brown. Gross haematuria is usually not associated with any other symptoms, but one can experience back pain or bladder pain if the body is trying to pass a blood clot.
Microscopic haematuria usually has no symptoms at all and is diagnosed when a urine sample is taken for an unrelated reason.
There is no one cause for haematuria. There are a variety of reasons people may have microscopic or gross haematuria, including:
Risk factors for haematuria include:
Your doctor will use a combination of a physical examination, medical history, and a test called a urinalysis to diagnose haematuria. A urinalysis is done when a sample of urine is given to a doctor to run tests on. In this case, they’ll primarily be looking for blood. Women should be aware that menstruating while giving a urine sample for haematuria can invalidate the results, and that they may need to test again when they are not menstruating.
If a urine sample has a lot of blood in it, your doctor may order additional tests to make sure there are no other problems. These can include lab tests, a computerised tomography (CT) scan or X-ray of the urinary tract, a kidney biopsy, or a cystoscopy to look inside your urethra.
Complications of haematuria include the cause of the haematuria going untreated and side effects of medications. If a serious health problem is causing haematuria, and it’s not being treated, it could lead to problems later. Additionally, depending on the cause of haematuria, medication may be used for treatment. The medication may cause undesired side effects.
Treatment for haematuria is based on the cause. Sometimes, haematuria requires no treatment. Certain treatments include taking antibiotics for an infection, trying medication for a swollen prostate, or working on breaking up urinary stones. Similarly, cancer requires cancer-specific treatments, like chemotherapy, radiation, or monitoring progression of a tumour. Kidney disease, sickle cell disease, and endometriosis will all require disease-specific treatments that your doctor can advise you on.