Haematuria and Bladder cancer

Haematuria or blood in the urine may be visible (macroscopic) or found on urine tests (microscopic haematuria).

  • Macroscopic  Haematuria - where you can see blood in the urine. This may be due to to urinary infection, kidney stones, or serious underlying problems such as kidney or bladder cancer.
  • Microscopic Haematuria - where a urinalysis (dipstick test) or MSU may suggest microscopic numbers of blood cells in the urine. 

If you see blood in your urine you need to see your GP urgently for tests, and you will probably need referral to a Urologist or Renal Physician.

What other tests may be needed?

  • A mid-stream urine test (MSU) - to confirm microscopic bleeding and exclude infection
  • Urine cytology - (macroscopic haematuria only) to see if there are any abnormal or cancer cells in the urine under the microscope
  • Ultrasound of the urinary tract or CT/IVP

Your GP may order some or all of these tests prior to your Specialist appointment.

What does the Urologist do?

  • Initial consultation - medical history, physical examination and a review of all Pathology and Radiology results
  • Diagnostic cystoscopy - to inspect the bladder/lower urinary tract to find the cause of bleeding, This is usually done under local anaesthetic as a walk-in, walk-out procedure.

Bladder Cancer

Bladder cancer (Transitional Cell Cancer) starts in the "Transitional" cells lining the urinary "tubes" coming out of the kidney and the bladder. It usually grows on the surface, projecting into the tube like a polyp. But it may grow more aggressively and invade into the wall of the bladder.

Bladder cancer usually presents with blood in the urine (or haematuria). Anyone with visible blood in the urine (not due to infection) needs referral to a Urologist for further investigation to exclude a Kidney or Bladder cancer or other urinary tract pathology.