4urology

Haematuria is the presence of red blood cells (RBCs) in the urine. In invisible haematuria (also known as microscopic haematuria), the urine appears normal to the naked eye, but examination with a microscope shows a high number of RBCs. Visible haematuria (also known as gross or macroscopic haematuria) can be seen with the naked eye—the urine ranges in colour from rose to red to the colour of cola. The colour is dependent on the amount of the blood, where the bleeding is coming from and how long it has been bleeding for.

Several conditions can cause haematuria, most of them not serious. For example, an enlarged prostate may cause haematuria or exercise may cause haematuria that can settle within 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 of the kidney, bladder or prostate or due to other serious problems, a doctor should always 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, kidney imaging studies, 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, which are 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.
• Kidney imaging studies include ultrasound, computerised tomography (CT) scan, or intravenous pyelogram (IVP). An IVP is an x-ray of the urinary tract. Imaging studies 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.