Blood in urine (Haematuria)

Haematuria (blood in the urine) can be caused by a wide range of conditions, some harmless and others more serious. Common causes include:

• Urinary tract infections (UTIs) – irritation or inflammation from an infection can cause blood to appear in the urine.

• Kidney stones – sharp stones can scratch the lining of the urinary tract, leading to bleeding.

• Enlarged prostate (BPH) – in men, an enlarged prostate can press on the bladder and cause bleeding.

• Vigorous exercise – intense physical activity can occasionally lead to temporary haematuria.

• Bladder or kidney infections – these can cause inflammation and bleeding.

• Injury or trauma – to the kidneys or bladder.

• Certain medications – such as blood thinners or anti-inflammatories.

• Kidney disease – some kidney conditions cause microscopic bleeding.

• Cancer – in the bladder, kidney, or prostate (especially in older adults or smokers).

Because the cause can range from minor to serious, any case of haematuria should be evaluated by a doctor, even if it’s painless or discovered incidentally.

If haematuria is evident, further testing may be required. This can include:

• Urine tests – to check for infection, abnormal cells, or other signs of kidney or bladder problems.

• Blood tests – to assess kidney function and look for signs of underlying conditions.

• Imaging scans – such as an ultrasound, CT scan, or MRI to view the kidneys, ureters, and bladder for stones, tumours, or other abnormalities.

• Cystoscopy – a thin, flexible camera is passed into the bladder through the urethra to look directly at the bladder lining. This is especially useful if you're over 35 or have visible haematuria.

• Urine cytology – a lab test that checks for cancerous or abnormal cells in the urine.

The type and extent of testing will depend on factors like your age, symptoms, and whether the haematuria is visible or microscopic. The goal is to rule out serious conditions and guide appropriate treatment if needed.

Treatment for haematuria depends entirely on the underlying cause — the goal is to manage the source of the bleeding rather than the symptom itself. Once your doctor identifies what's causing the blood in your urine, treatment may include:

• Antibiotics – if a urinary tract infection (UTI) is the cause.

• Medications or procedures – for conditions like an enlarged prostate (BPH) or kidney stones.

• Lifestyle changes – such as adjusting medications, increasing fluid intake, or managing strenuous exercise if that's a trigger.

• Surgical treatment – may be needed for structural problems, tumors, or persistent bleeding.

• Ongoing monitoring – in some cases, especially with microscopic haematuria that isn’t linked to a serious cause, your doctor may simply monitor your condition over time.

The key is early assessment, as prompt diagnosis allows for more effective and tailored treatment — and peace of mind.