Blood in Urine (Haematuria)
Blood in the urine could be a sign of underlying disease of the urinary system, including bladder and kidney cancer or diseases of the kidney. It should not be ignored and if concerned you should seek a specialist opinion from a Urologist and sometimes a kidney doctor.
Are there different types of Haematuria?
Blood in the urine can be non-visible or visible. If non-visible, the risk of underlying cancer is thankfully quite low (5% but may increase with age).
If you have symptoms such as pain on passing urine, poor flow or even pain in the loins that could point to urological conditions such as kidney stones, urine infections, bladder inflammation, prostate enlargement or sometimes bladder cancer.
You would benefit from a risk assessment to explain whether a scan of the kidneys and a camera (cystoscopy) to inspect the bladder, urethra and prostate (in men) is required.
Non-visible blood in the urine is very commonly picked up incidentally at your GP surgery. This may not always require assessment. It is important not to over-investigate this as some tests such as CT (Computed-tomography) scans may carry too high a risk of radiation to justify the test, particularly if you are younger.
Sometimes blood in the urine picked up on a urinalysis stick test, is caused by kidney diseases associated with other conditions such as diabetes or hypertension (raised blood pressure). These conditions are on the rise and further simple tests such as assessing protein in the urine can help determine the true cause of blood in the urine.
What should I do if I see blood in my urine?
This would suggest visible haematuria and if new and not associated with other symptoms suggestive of an infection of the bladder, carries a higher risk of a cancer (around 30%), which could be from the bladder, prostate or kidney. Therefore an urgent assessment by a Urologist is strongly recommended.
Again your risk of having cancer will be assessed by a Consultant Urologist and tests including a CT scan and cystoscopy will be discussed with you.
What if the cystoscopy picks up a bladder tumour?
If the bladder inspection detects a bladder tumour, thankfully around 70% will be superficial tumours, which do not invade to the deeper layers of the bladder wall and the majority of these will not be dangerous to life. However they may have a tendency to recur. A simple operation is usually recommended to remove the tumour(s) called a transurethral resection of a bladder tumour (TURBT). Sometimes a common chemotherapy agent (mitomycin) is recommended to reduce the recurrence rate. This is not systemic treatment, but is injected directly into the bladder via a urethral catheter for a short period, up to 1 hour. Therefore you do not have the risk of hair-loss.
Less commonly, a more aggressive form of bladder cancer is detected which does invade deeper into the bladder wall. This may not be suitable for TURBT alone and may require more intensive treatment including removal of the bladder or radiotherapy with chemotherapy (systemic).
Can I be tested and treated for bladder cancer at One Ashford Hospital?
Yes – if you have experienced blood in the urine and require an urgent specialist opinion we can perform all the necessary tests above and remove a bladder tumour with a TURBT procedure. Your consultant can then advise on whether further treatment or follow-up tests are required after risk assessing the bladder tumour.
Mr Milan Thomas
Consultant Urological Surgeon
Mr Milan Thomas FRCS (Urol)
Milan Thomas is a Urological Surgeon and specialist in diagnosing and treating Urology Cancers. His training included an Honours degree in Cancer Biology at University College London. He gained significant experience of cancer treatments at teaching hospitals on the Manchester Training Programme including The Christie Hospital. He is Lead Clinician for Urology at East Kent NHS Trust and performs surgery using the da Vinci Robot.
For learn more about Mr Thomas, please click here
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