Hematuria – Blood In The Urine

Chances are high of you having gross hematuria (visible blood in the urine) if the colour of your urine ranges from pink to red and brown. Normal urine should be pale yellow to dark yellow depending on how hydrated you are. You can also find out if you have microscopic hematuria via a urine test.

Pink urine can just be a sign of infection, such as urinary tract infection (UTI), which can be managed with antibiotics.

However, it is advisable you consult a urologist to determine if there are infections, stones or malignancies (tumour or cancer) if the blood in your urine persists, despite the treatment of UTI.

The presence of pain during urination, such as pain in the abdomen and/ or a burning sensation while you pee alongside blood in the urine can be symptoms of a urinary tract infection or stones (urolithiasis).

The real worry is the presence of malignancies (kidney or bladder tumour or cancer), in which you may experience painless pink urine.

• Routine blood investigation
• Urine FEME
• Urine culture examination
• Urine cytology examination
  • A test where the doctor looks at the cells collected from a urine specimen to see how they look and function. The test commonly checks for an infection, inflammatory disease of the urinary tract, cancer, or precancerous conditions.

• Imaging tests such as an ultrasound of the kidneys, urinary tract and bladder
• CT scan KUB 4 phase
• Cystoscopy
  • A procedure that allows your doctor to examine the lining of your bladder and the tube that carries urine out of your body (the urethra). A hollow tube (cystoscope) equipped with a lens is inserted into your urethra and slowly advanced into your bladder.

Our urologist can help you stop the bleeding; locate the size and site of the injury; and do a biopsy of the tumour or cancer. Depending on the diagnosis, with the possibility of:

1. a bladder tumour; hence our urologist can perform an endoscopic treatment to remove the tumour (TURBT). If detected late, you may need to remove the entire bladder and be dependent on a urostomy bag to help you pass urine, which is a lifelong process. Therefore, it’s important for you to detect cancer early so that you can still maintain a healthy quality of life.
2. stone formation; with early detection and management, you can avoid complications such as renal impairment that can lead to end-stage renal disease that requires lifelong dialysis.

The following are some of the common causes of hematuria but are not limited to:

• Cancer (the most dangerous cause)
• Stones (the most common cause)
• An infection
• Blood clotting disorder
• Injury
• Inflammation of the kidney, urethra, bladder or prostate
• Immunological disorder

This article was contributed by Dr Toh Charng Chee, Consultant Urologist at Pantai Hospital Ampang. To know more about where and when to see Dr Toh Charng Chee at his clinic, click here.