Haematuria (Blood in the Urine)

Haematuria is the presence of red blood cells (RBCs) in the urine. In microscopic haematuria, the urine appears normal to the naked eye, but examination under a microscope shows a high number of RBCs. Gross haematuria can be seen with the naked eye—the urine is red or the colour of cola.

Several conditions can cause haematuria, most of them not serious. For example, exercise may cause haematuria that goes away in 24 hours. Many people have haematuria without any other related problems. Often no specific cause can be found. But because haematuria may be the result of a tumour or other serious problem, a doctor should be consulted.

To find the cause of haematuria, or to rule out certain causes, the doctor may order a series of tests, including urinalysis, blood tests, intravenous pyelogram, and cystoscopic examination.

Urinalysis is the examination of urine for various cells and chemicals. In addition to finding RBCs, the doctor may find white blood cells that signal a urinary tract infection or casts (groups of cells molded together in the shape of the kidneys' tiny filtering tubes) that signal kidney disease. Excessive protein in the urine also signals kidney disease.

Blood tests may reveal kidney disease if the blood contains high levels of wastes that the kidneys are supposed to remove.

An intravenous pyelogram (IVP) is an x ray of the urinary tract. An IVP may reveal a tumour, a kidney or bladder stone, an enlarged prostate, or other blockage to the normal flow of urine.

A cystoscope can be used to take pictures of the inside of the bladder. It has a tiny camera at the end of a thin tube, which is inserted through the urethra. A cystoscope may provide a better view of a tumour or bladder stone than can be seen in an IVP.

Treatment for haematuria depends on the cause. If no serious condition is causing the haematuria, no treatment is necessary.