Overview
There are two types of haematuria: visible and non-visible.
Visible (gross/frank) haematuria is when your urine appears red. This is a more worrisome condition than non-visible haematuria as there is an associated risk of cancer within the urinary tract in up to a third of those affected.
Visible haematuria warrants more detailed investigation due to the higher risk of detecting malignancy within the urinary tract.
Non-visible (microscopic) haematuria is when red blood cells are seen under a microscope in your urine. This is defined as ≥ 3 red blood cells per high power field in an appropriately collected urinary sample.
It is a relatively common condition, affecting 2-30% of the population, with higher rates in males aged > 60 years old and ex/current smokers. There is an estimated 3-5% risk of cancer within the urinary tract with microscopic haematuria.
However, do note that blood seen on a urine dipstick does not mean that it is haematuria and warrants microscopic examination of the urine for confirmation.
Causes
- Urinary tract infection
- Urinary stones
- Prostate enlargement
- Benign Prostate Enlargement
- Cancers of the urinary tract including kidney, bladder, prostate, ureter
Detection & Treatment
What tests are required?
Visible Haematuria
- A urine culture is required to check for the presence of a urinary infection.
- Detailed imaging in the form of Computed Tomography (CT) Urography or Magnetic Resonance Imaging (MRI) is required to look for the cause.
- A flexible cystoscopy is required for all, especially those aged 35 years and above, as imaging may not detect small bladder tumours.
Non-visible Haematuria
- Your doctor will discuss with you regarding suitable imaging options.
- These can include an ultrasound of the kidneys, ureters and bladder, an X-ray or a Computed Tomography (CT) scan.
- A flexible cystoscopy is highly recommended for all with risk factors for cancers of the urinary tract. These risks include smoking history, certain chemical exposures and previous radiation to the pelvis.
Specialties & Services
