Haematuria: blood in the urine

Haematuria means blood in the urine. It can be macroscopic (visible), when the urine is visibly pink, red or ‘cola-coloured’, or microscopic, when it is only detected by a urine test.

The golden rule

Visible haematuria should always be assessed by a urologist: even if it appears only once, even if it does not hurt, even if it then goes away on its own. It is precisely painless haematuria that can be the first sign of a bladder or kidney cancer.

Is it really blood?

Some foods (beetroot, blackberries), some medicines and menstruation can colour the urine; intense physical exertion can cause transient traces of blood. A simple urine test clears up any doubt.

Possible causes

• bladder and prostate infections
• stones in the kidney, ureter or bladder
• enlarged prostate
• cancers of the bladder, kidney, upper urinary tract or prostate
• kidney diseases
• injuries

Anticoagulant medicines can make bleeding more likely but do not explain it on their own: the cause must still be looked for.

The tests

Urinalysis and urine culture, urine cytology, ultrasound, CT urography and cystoscopy, that is, a direct look at the inside of the bladder.

Who is most at risk

Cigarette smoking is the main risk factor for bladder cancer. Age and occupational exposure to chemicals, such as dyes, paints and rubber derivatives, also play a part.