written by Dr George Lee Eng Geap on 28 December 2011


Haematuria is the presence of blood in the urine. It can be either “frank” (visible to the naked eye), or
microscopic. Microscopic haematuria usually is an incidental finding after a routine medical check-up.
How common is haematuria?
It is estimated that hematuria can occur in up to 20% of the population. Haematuria may be a marker for infection, stone disease or urinary tract cancer.
How serious is haematuria?
Blood in the urine is often not a sign of significant disease. One of the commonest cause of haematuria is urinary tract infection, such as cystitis, which is more common in pregnant, sexually active and elderly women. Haematuria can also be a sign of an important medical condition such as bladder, kidney, prostate, ureteral or urethral cancers. Other conditions that can cause haematuria are stone disease, renal disease, benign prostate disease, trauma or even exercise
What other symptoms can I get?
Patient may have no other symptoms apart from the visible haematuria, which often prompts urgent medical attention and microscopic haematuria is usually diagnosed during routine medical evaluation.
What should I do if I have haematuria?
Any patient with haematuria should have further evaluation of the urinary tract. You should see a family practitioner or a specialist (Urologist) for more tests. The urine will be examined to confirm the presence of blood cells and to exclude infection, presence of protein or cancer cells. Your doctor may also carry out some blood tests.
Your urinary tract may be evaluated by X rays such as IVU (Intravenous Urogram). The test involves a radiographic dye is injected into the blood stream and serial X-rays are taken as the kidneys excrete the dye. This test is useful to exclude blockage, stones and tumours. Ultrasound or the CT (Computer Tomography) of the Kidneys and the bladder may also be carried out.
Cystoscopy, which is the endoscopic examination of the bladder will also be carried out. This can either be a flexible cystoscopy which is performed in the office under local anaesthesia. After applying a local lubricating anaesthesia, the doctor will inserts a telescope through the urethra into the bladder and looking for abnormality. Occasionally, this procedure is done under general anaesthesia with rigid telescope.
What happens if no abnormality is found?
If there is no abnormality detected, you may still need further follow up or evaluations. The above tests may need to be repeated.
How will hematuria be treated?
Treatment will be based on patient's condition and the cause of the haematuria.