Haematuria Assessment

Haematuria, or blood in the urine may be visible bleeding (macroscopic) or may be found on testing the urine with a dipstick test or in a laboratory test (microscopic). 

Blood in the urine may be due to a number of causes such as urinary infection, kidney stones, prostate disease or more serious underlying problems such as kidney or bladder cancer. 

If you see blood in your urine you should see your GP urgently for tests:
• A mid-stream urine test (MSU) – this will confirm microscopic bleeding and diagnose any infection that might be present 
• Urine cytology – to see if there are any abnormal or cancer cells in the urine under the microscope 
• Ultrasound of the urinary tract or CT/IVP 

If there is bleeding without infection, you will probably need referral to a Urologist or Renal Physician. 

What does the Urologist do? 
• Initial consultation – medical history, physical examination and a review of all Pathology and Radiology results 
• Diagnostic cystoscopy – a direct inspection using a small flexible telescope to look at the lower urinary tract to find the cause of bleeding, This is usually done under local anaesthetic as a walk-in, walk-out procedure.

Urothelial cancer of the Bladder 
Bladder cancer grows from the cells lining the urinary tract (in the kidney tubes/renal pelvis, ureter, bladder and urethra). These are usually slow growing superficial cancers, but some are more aggressive and invade into the wall of the bladder.
The first sign of Bladder cancer is usually blood in the urine.