Dear doctor, I've recently seen blood in my urine. What could be the cause of this?

10 June 2019

Q: I have recently seen blood in my urine. What could be the cause of this?

A: Blood in the urine is most likely a result of a non-cancerous condition such as a bladder infection, kidney stones, or even due to drugs or food (such as beetroot) colouring the urine red. It can however also be a sign of a more serious underlying condition such as bladder cancer - particularly if there are risk factors such as a history of smoking. For this reason, proven blood in the urine whether visible or non-visible should always be investigated.

Simple tests performed by the GP such as; a medical history, clinical examination, blood pressure measurement, blood and urine tests, and treatment for any infection that is found may be all that is required.

Some patients may be referred on for specialist investigation by a urologist if any of the following apply:

  • You are over 45 and have visible blood in the urine in the absence of infection
  • The blood fails to clear following antibiotic treatment for urinary infection
  • You have non-visible blood but significant urinary symptoms
  • You are over 60 and have non-visible blood with a high white blood count on a blood sample or discomfort when you are passing urine

Up to one in six adults with visible blood in the urine and one in 16 adults with non-visible blood in the urine are subsequently found to have bladder cancer. If detected early, the majority of cases can be successfully treated, but early investigation and treatment is crucial. With non-visible blood in the urine, only 10% will have a cause identified and may require treatment.

Half of patients with visible blood in the urine will have an underlying cause identified. I would recommend you are seen by a specialist who will be able to advise on the most appropriate treatment.

Mr Daniel Wilby is a Consultant Urologist practising at Spire Portsmouth Hospital.

The content of this article is provided for general information only, and should not be treated as a substitute for the professional medical advice of your doctor or other health care professional.

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