Blood in the urine

Noticed blood in your urine? Or your doctor has informed you that you have blood in the urine?

Whether it appears once or occurs repeatedly, it can be alarming and understandably concerning.

Blood in urine, also known as haematuria, may be caused by minor conditions, but it can also be an early sign of more serious underlying issues.

Haematuria without pain or discomfort may be a red flag for more serious conditions, including bladder, kidney, or prostate cancer. 

Haematuria accompanied by pain is more commonly associated with conditions such as kidney stones or urinary tract infections.

Image from designua/Adobe Stock

Why Does Blood in Urine Appear: Causes & Risk Factors

Blood in urine can occur for a variety of reasons, ranging from minor and temporary conditions to more serious underlying causes.

While some causes are easily treatable, others require prompt medical attention. Understanding the possible causes is the first step towards receiving appropriate care and ensuring timely diagnosis.

Common Causes

These are some of the more frequently seen reasons for blood in urine:

• Urinary Tract Infections (UTIs)
  Infection in the bladder or urinary tract can cause irritation and bleeding.
• Kidney Stones
  Hard deposits can irritate the urinary tract, leading to pain and visible blood.
• Prostate Conditions
  Enlargement or inflammation of the prostate may result in blood in urine.
• Strenuous Exercise
  In some cases, intense physical activity may cause temporary haematuria.
• Kidney disorders
  Inflammatory conditions affecting the kidney may cause blood in the urine.

More Serious Causes

In certain cases, blood in urine may be caused by more serious conditions:

• Bladder Cancer
• Kidney Cancer
• Prostate Cancer

Blood in urine may sometimes be the only early warning sign of these conditions, particularly when it occurs without pain. 

Risk Factors to Be Aware Of

Some individuals may have a higher risk of underlying conditions:

• Age above 40
• Smoking history
• Recurrent urinary infections
• Previous kidney stones
• Family history of urinary or kidney conditions

Important to Know

Blood in urine can appear:

• Once or multiple times
• With or without pain
• Suddenly, without other symptoms

Even if it resolves on its own, it should not be ignored.

Recognising the Symptoms

You may be experiencing one or more of the following symptoms: 

• Pink, red, or brownish urine
• Blood clots in urine
• Pain or discomfort during urination
• Lower back or flank pain
• Increased frequency or urgency to urinate

If you notice any of these symptoms, it is advisable to seek medical assessment for further evaluation. 

Types of haematuria

• Visible (gross haematuria): urine appears red or brown
• Microscopic haematuria: only detected through lab tests

Both types may require medical evaluation

When to see a doctor?

When should you seek medical attention?

• You notice blood in your urine (even once)
• There was blood in the urine detected through lab tests
• Symptoms persist or recur

Don’t wait for symptoms to worsen.

To determine the underlying cause of blood in urine, a structured evaluation is performed.

It is important to assess the entire urinary tract, including the kidneys, ureter, bladder (and prostate in men).

Assessment & Diagnostic Approach

To determine the underlying cause of blood in urine, a structured evaluation is performed: 

1. Clinical Consultation & Symptom Assessment
   A comprehensive review of your symptoms, medical history, and relevant risk factors. 
2. Laboratory Investigations (Urine & Blood Tests)
   To assess for infection, evaluate kidney function, and detect any abnormalities. 
3. Imaging Studies (Ultrasound or CT Scan)
   To identify possible causes such as kidney stones, tumours, or structural abnormalities within the urinary tract. 
4. Flexible cystoscopy (if required)
   A minimally invasive procedure that allows direct visual examination of the bladder using a thin flexible endoscope. The procedure can be performed using local anaesthetic gel or under intravenous sedation, and usually takes ten minutes or less.

Flexible cystoscopy (image from Cancer Research UK)

Treatment options for blood in urine

Treatment depends on the underlying cause.

For infections

• Antibiotics

https://www.urospecialist.com.sg/condition/urinary-tract-infection/

For kidney stones

• Medication
• Minimally invasive procedures

https://www.urospecialist.com.sg/condition/kidney-stones/

For prostate-related conditions

• Medication or surgical procedures

https://www.urospecialist.com.sg/condition/prostate-enlargement/

For more serious conditions

• Click the links below for treatment of bladder, kidney and prostate cancer

https://www.urospecialist.com.sg/condition/bladder-cancer/

https://www.urospecialist.com.sg/condition/kidney-cancer/

https://www.urospecialist.com.sg/condition/prostate-cancer/

The key is identifying the cause early and treating it appropriately.