Blood in the urine: why it should never be ignored

Common causes

Stones and urinary infections are the most frequent reasons, and both usually come with pain or burning. An enlarged prostate can also bleed. The cause that matters most to exclude is a tumour of the bladder or kidney, which characteristically bleeds without any pain at all.

• Kidney, ureter or bladder stones
• Urinary tract infection
• Enlarged prostate
• Bladder or kidney tumour
• Injury to the urinary tract

What the evaluation involves

A urine test and culture come first, followed by an ultrasound of the kidneys, ureters and bladder. Depending on the findings and your age, a CT scan and cystoscopy — a short telescopic look inside the bladder — may be advised. Cystoscopy is the only reliable way to see the bladder lining.

One episode is enough to investigate

Patients often wait because the bleeding stopped by itself. Tumours bleed intermittently, so a single episode that settles is not reassuring. If you have seen blood in your urine even once, book a consultation.