Blood in the urine is a common symptom that brings individuals to visit the doctor. In many instances the cause is harmless, but blood in urine (haematuria) can indicate a serious disorder including cancer.
Blood in the urine
When large amounts of blood are in the urine it is called gross hematuria and causes the urine to look pink, red or cola-coloured due to the presence of red blood cells. In some instances, blood is only visible under a microscope (microscopic haematuria) and is found when your doctor performs a test on your urine. In both cases, this symptom should not be ignored. In many cases bloody urine often occurs without other signs or symptoms.
What causes blood in the urine?
If there is blood in your urine, it will likely have come from somewhere within the urinary tract – the kidneys, bladder or ureters/urethra the tubes that urine passes through.
Common causes of blood in urine include:
• a bladder infection (such as cystitis)
• a kidney infection
• kidney stones
• Urethritis – inflammation of the tube that carries urine out of the body (urethra)
• an enlarged prostate gland – this is a common condition in older men and nothing to do with prostate cancer. An enlarged prostate gland will press on the bladder and may also cause problems such as difficulty urinating and a frequent need to urinate
• bladder cancer – this usually affects adults aged over 50 (but not exclusively) and can also cause you to urinate more often and more urgently, as well as pain when urinating
• kidney cancer – this also usually affects adults aged over 50, (but not exclusively)
• prostate cancer – this is only seen in men, usually aged over 45 (but not exclusively)
• inherited disorders. Sickle cell anemia — a hereditary defect of haemoglobin in red blood cells — causes blood in urine, both visible and microscopic haematuria
• Kidney injury. A blow or other injury to your kidneys from an accident or contact sports can cause visible blood in your urine.
• Medications. The anti-cancer drug cyclophosphamide and penicillin can cause urinary bleeding. Visible urinary blood sometimes occurs if you take an anticoagulant such as aspirin and the blood thinner heparin, and you also have a condition that causes your bladder to bleed.
When to see your doctor?
You should always see your doctor if you notice bright red blood in your urine, or if your urine has turned red or brown. Women who are having their menstrual cycle might notice blood in the urine. If this does not disappear after the menstrual period ends, they should also see their doctor.
Making the diagnosis
A detailed medical history and examination is important. Your doctor will arrange a number of tests and investigations. Once a diagnosis is made treatment can begin. Sometimes, the cause of urinary bleeding cannot be found. In that case, your doctor might recommend regular follow-up tests, especially if you have risk factors for bladder cancer, such as smoking, exposure to environmental toxins or a history of radiation therapy.
Treatment
The type of treatment will depend on the condition causing the haematuria. In some cases, no treatment is necessary. It is important to follow your doctor’s instructions and also keep follow up appointments.
Conclusion
Blood in the urine in most cases is causesdby not too serious conditions, but in some cases it can be a sign of cancer. Blood in urine must be checked out by a doctor as soon as it is noticed, because it can be a sign of cancer such as cancer of the kidneys, bladder and prostate. The earlier the cancer is diagnosed and treated the better is the prognosis. Men in particular, if you notice blood in the urine do not ignore it – see a doctor.
Ask Your Dr is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge MB BS DGO MRCOG is an obstetrician/Gynaecologist and Family Doctor with over thirty-six years in clinical practice. Dr Brett Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 497 5928).
