Haematuria means blood is present in the urine — sometimes visible as pink, red, or cola-coloured urine, and sometimes detectable only under a microscope or dipstick test. It's a symptom, not a disease in itself, and the underlying causes range from harmless to serious.
Microscopic (invisible) blood in urine affects an estimated 6.5% of the general population, more common in older men, with some studies reporting rates as high as 21% (NIH).
Causes & risk factors
- Urinary tract or kidney infection
- Kidney or bladder stones
- Enlarged prostate (BPH)
- Vigorous exercise (usually harmless and temporary)
- Chronic kidney disease
- Urologic cancers — found in about 5% of microscopic and 20% of visible haematuria cases (NIH/Cleveland Clinic)
Symptoms to watch for
- Pink, red, or cola-coloured urine
- Blood clots in the urine
- Pain or burning during urination, if infection-related
- Flank or lower back pain
- Painless visible blood in urine must be evaluated promptly to rule out cancer; fever, chills, or inability to urinate are also urgent
How it's diagnosed
- Urinalysis and urine culture
- Urine cytology (checks for abnormal cells)
- Cystoscopy — a camera scope examines the bladder and urethra directly; the key test for unexplained or visible blood
- Imaging: CT urogram, ultrasound, or MRI
Treatment options
- Antibiotics: if the cause is a urinary infection.
- Prostate medication: alpha-blockers or 5-alpha reductase inhibitors if BPH is the cause.
- Stone treatment: as above (SWL, ureteroscopy, RIRS or PCNL) if a stone is responsible.
- Cancer-specific therapy: surgery, radiation, or other treatment if a tumour is found.
- Observation: mild, exercise-induced haematuria often needs no treatment at all.
Outlook & prevention
Haematuria itself usually isn't life-threatening, but the underlying cause determines the outcome — so timely evaluation matters, especially for painless visible blood. A urologic cancer is found in roughly 1 in 5 people who have visible blood in urine, which is why full evaluation should never be skipped, even after a single episode.
- Any visible blood in the urine, even a single, painless episode
- Blood in urine together with fever, flank pain, or difficulty urinating
- Microscopic blood found incidentally on a routine urine test