Haematuria
What is Haematuria?
Haematuria is the presence of blood in the urine. Haematuria can be classified into 2 types:
- Microscopic haematuria –
Where the blood is not visible and present only on testing of the urine. - Macroscopic haematuria –
Where there is visible blood in the urine causing it to be discoloured pink, red, brownish-red or tea-coloured. Gross haematuria is another term for visible blood in the urine.
Learn why it’s important to not ignore blood in urine
Blood in the urine can originate from any part of the urinary tract ranging from the kidneys, collecting system (ureters and bladder) as well as from the urethra (waterpipe) taking urine from the bladder.
Urine testing for haematuria should only be done for identifiable clinical reasons, rather than as a form of population health screening.
Classification of Haematuria
- Symptomatic – associated with voiding symptoms such as:
- Hesitancy (slow urination)
- Frequency
- Urgency
- Dysuria – burning or pain on urination
- Abdominal or flank pain
- Asymptomatic – occuring without symptoms
Frequently Asked Questions on Haematuria
How often does Haematuria occur?
What are the common causes of Haematuria?
Urinary tract infection (UTI) is one of the most common causes of haematuria. Stones within the urinary tract (kidney or ureteric) can also cause blood in the urine. Urinary tract cancers such as kidney cancer and cancers of the bladder (TCC – transitional cell cancer – of the lining of the urinary tract) are also important causes of haematuria.
What is the significance of Haematuria?
Not all haematuria is caused by significant problems in the urinary tract.
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 ranges between 3 to 6% but has been reported to be as high as 19% in some studies.
Are there risks for Urinary Tract Cancers?
Risk factors for Urinary Tract Cancers (or malignancy) include:
- Increasing age, especially > 40 years
- History of smoking (both current and past)
- Occupational exposure to dyes in the print and clothing industries, benzenes
- Exposure to medications such as cyclophosphamide and phenacetin
- Previous pelvic radiation
- History of macroscopic or visible haematuria
- Significant bladder symptoms in the absence of a urinary infection such as urgency, frequency, pain or discomfort on urination
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