Haematuria (Blood In Urine or Pee)
The presence of blood in the urine means that there could be a problem in any part of the urinary tract - the kidneys, ureters, bladder, prostate gland or the urethra. This is why it's so important to see your doctor straight away. Chances are it's nothing serious, but you're not wasting anyone's time by getting it checked out. Call your GP today. Early detection makes it easier to treat. Seeing your doctor could save your life.
Blood in the urine can be visible or nonvisible. The ways of checking for bood in the urine include:
- Dipstick haematuria (pick up on routine screening by a simple dipstick test)
- Microscopic haematuria (detected under the microscope)
- Macroscopic haematuria (seen as red or brown discoloration of the urine)
What is the likelihood the symptoms are serious?
It is very rare that patients under the age of 40 years with dipstick/microscopic haematuria have a serious problem.
Patients with visible haematuria were more likely to have a diagnosis of urinary tract cancer compared with non-visible haematuria patients (13.8% vs 3.1%). Older patients, male gender, and smoking history increasing the chance of urinary tract cancer diagnosis.
10% of patients with haematuria will have a malignancy (bladder cancer 8.0%, renal cancer 1.0%, upper tract transitional cell carcinoma 0.7%, and prostate cancer 0.3%).
50% of patients with haematuria will have an abnormality (infection, stricture, stone, cancer , benign prostatic hyperplasia, injury, blood disorders, medical reasons - glomerulonephritis , etc...)
One Stop Haematuria Service
East Kent Urology (EKU) Department of EKHUFT has a wide range of specialists in haematuria, urology and urological oncology that can assess the likelihood of disease.
The appointment takes around 30 minutes and includes:
- Urine dipstick test on arrival
- A physical examination including a digital rectal prostate examination for a man and basic external gynecological examination for a female
- Flexible cystoscopy under local anaesthesia (anesthetic gel applied into the urethra}. This is an investigation involving a tube being passed through the urethra into the bladder for direct visual inspection of urethra/prostate/bladder.
- CT Scan of your kidneys, bladder and tubes that drain urine from kidneys to bladder (CT Urogram) or Ultrasound to visualize the urinary system (aiming to have in one day , but appointment for scan can come prior or after the main haematuria clinic date, in this case the patient will be informed about the results over phone and/or letter).
- A blood test to establish kidney function and PSA Biomarker test for prostate cancer if not done by GP.
- Optional Flow rate test involving to test the amount of urine voided during urination, the speed of urination and residual volume of urine in the bladder afterwards.
We aim to provide you with a fast track service to ensure you are fully informed of the likely diagnosis and options available to you.
More info and leaflets:
The British Association of Urological Surgeons - Blood in urine, patient information
The British Association of Urological Surgeons - Flexible Cystoscopy patient leaflet
Having a flexible cystoscopy: examining your bladder, patient leaflet