Patient information · Urology
Blood in urine
one episode is enough to need investigating
Visible blood in the urine is alarming and is usually caused by something benign — an infection or a stone. But it is also the commonest presenting sign of bladder cancer, and the bleeding characteristically stops on its own. That is the trap: people wait to see whether it happens again, and it does not, and years pass.
Seek urgent assessment if you have
- blood with clots, or difficulty passing urine because of clots
- inability to pass urine at all with a painfully full bladder
- blood with fever, shivering and loin pain
- blood with severe abdominal or flank pain
- dizziness, faintness or a racing heart alongside heavy bleeding
- blood in the urine following significant injury
Clot retention — being unable to pass urine because clots are blocking the outlet — is painful and needs a catheter urgently. In an emergency call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
Painless visible blood is the one to act on
Bleeding that comes with pain is more often a stone or infection. Painless visible blood in the urine, particularly over the age of 45, requires urgent investigation for bladder and kidney cancer. It is typically intermittent — it appears once, resolves completely, and the person concludes it has sorted itself out. It has not. A single episode is a reason to be seen, not to wait for a second.
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
Things that look like blood and are not
Beetroot, blackberries, rhubarb and certain food colourings can turn urine red. So can some medicines — rifampicin, nitrofurantoin, senna. Menstrual blood is a common explanation in women and the test should be repeated at another point in the cycle. None of these should be assumed without testing.
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.
This is exactly the sort of thing to get looked at quickly rather than added to a waiting list. We can see you the same day, seven days a week, with urine and blood testing in-house and results explained by a clinician, ultrasound performed on site, PSA testing available, CT arranged rapidly through our CQC-registered imaging partners, and consultant urology available without a GP referral. If you have seen blood once and it has stopped, that is still worth an appointment.
Same-day testing and urology, no referral needed
Ultrasound and bloods on site, seven days a week, 9am–7pm.
Tower Bridge Hospital London
97–99 Whitechapel Road, London E1 1DT
WhatsApp 07903 284 189
info@mhwclinic.co.uk
Open Mon–Sat, 9am–7pm (closed Sundays until September)
In an emergency
Call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
When we are closed and it is not an emergency
Call NHS 111 or visit 111.nhs.uk.