Private blood in urine clinic in London, same-day urology.

Two kinds

• Visible haematuria — urine that is pink, red, or the colour of tea or cola.
• Non-visible haematuria — blood detected only on a urine dipstick or laboratory test, usually found incidentally during a health check or insurance medical. It also needs assessment, though less urgently.

What causes it

• Urine infection — the commonest cause, usually with burning and frequency
• Kidney or bladder stones
• Prostate enlargement in men
• Bladder or kidney cancer — the reason investigation is not optional
• Kidney inflammation, which may show protein in the urine as well
• vigorous exercise, and occasionally anticoagulants unmasking another cause

What investigation involves

• Urine testing — dipstick, culture to exclude infection, and sometimes cytology
• Blood tests — kidney function, blood count, and PSA in men where appropriate
• Imaging — ultrasound of the kidneys and bladder, and CT where indicated
• Cystoscopy — a camera examination of the bladder, usually under local anaesthetic. This is the definitive test for the bladder lining and is the reason urology referral matters.
• Blood pressure and urine protein, since kidney disease can present the same way

Reducing your risk

Smoking is the single biggest risk factor for bladder cancer — responsible for around half of cases, and many people are unaware of the link. Occupational exposure to certain dyes, rubber, paint and industrial chemicals also raises risk, sometimes decades later. Staying well hydrated and treating urine infections properly help.