Seeing blood in your urine can be concerning, especially when you are unsure whether it warrants specialist attention. In other cases, blood may only be detected during a urine test, raising questions about what to do next.
Blood in the urine, medically known as haematuria, may require specialist evaluation when it persists, recurs or occurs alongside other concerning findings. A specialist can assess your symptoms, medical history and test results to determine whether further investigation of the kidneys or urinary tract is appropriate.
Understanding when to see a specialist for haematuria can help you seek appropriate evaluation and clarify the next steps in your care.
Key Takeaways
- Haematuria may be visible or only detected on urine testing.
- Common causes include UTIs, urinary stones and prostate conditions, though kidney and urinary tract diseases may also be responsible.
- Visible, persistent, or recurrent blood in urine should be medically assessed.
- Specialist review is especially important when risk factors or concerning symptoms are present.
- Depending on the suspected cause, assessment may involve a nephrologist, urologist or other appropriate specialist.
What Is Haematuria (Blood in Urine)?
Haematuria means that red blood cells are present in the urine. The bleeding can originate from different parts of the urinary system, including the kidneys, ureters, bladder or urethra. There are two main forms:
- Visible or gross haematuria occurs when enough blood is present to change the appearance of the urine. Urine may look pink, red or brown. Even a small amount of visible blood should be medically assessed, including when it occurs only once or causes no pain.
- Non-visible or microscopic haematuria cannot be seen by the naked eye. It is usually discovered through a urine test, sometimes during routine health screening or an investigation for another urinary problem.
Haematuria is therefore a symptom rather than a diagnosis. The important question is why bleeding is occurring.
When Should You See a Specialist for Haematuria?
Specialist evaluation may be appropriate when blood in the urine is visible, persists or recurs, remains unexplained or occurs alongside other concerning symptoms or risk factors. Depending on the suspected cause, assessment may involve a urologist, nephrologist or another appropriate specialist.
A specialist can review your symptoms, medical history and test results to determine whether further investigation of the kidneys or urinary tract is appropriate.
When Blood Is Visible
Visible blood should be medically assessed even when there is no pain, only a small amount of blood or just one episode. Painless haematuria should not be dismissed simply because you otherwise feel well.
When Haematuria Persists or Returns
Blood that continues after treatment for a suspected infection, repeatedly returns, or remains unexplained may require specialist evaluation.
When You Have Additional Risk Factors
Specialist assessment may become more important in older adults, smokers and people with a history of kidney disease or urinary conditions, or the use of medicines that can increase bleeding risk. Smoking in particular is associated with bladder and kidney cancers, both of which may present with haematuria.
When Other Concerning Symptoms Occur
Seek prompt medical attention if blood in the urine occurs with severe pain, fever, difficulty passing urine or other concerning urinary symptoms.
What Can Cause Haematuria?
Blood can enter the urine for a wide range of reasons and the accompanying symptoms may provide useful clues.
Possible Cause | How It May Present |
Urinary Tract Infections (UTIs) | Infection can irritate and inflame the urinary system, causing haematuria. Other symptoms may include burning during urination, increased frequency or urgency, cloudy or foul-smelling urine, fever or lower abdominal discomfort. |
Kidney or Urinary Stones | Stones can irritate the urinary tract and cause bleeding. Patients may also experience pain in the side, back or groin, depending on the stone's location. |
Prostate Conditions | In men, an enlarged prostate can contribute to haematuria. Other symptoms may include difficulty starting urination, a weaker urinary stream, incomplete emptying or increased urinary frequency. |
Kidney and Urinary Tract Conditions | Kidney inflammation, structural abnormalities, injuries and certain blood or vascular disorders may cause haematuria. Bladder, kidney, ureteric and prostate cancers can also present with blood in the urine, particularly visible haematuria. |
Seek Specialist Care for Haematuria at The Kidney Health Care Clinic
If blood in your urine persists, returns or is clearly visible, a specialist evaluation can help clarify whether further investigation is needed. Rather than relying on the appearance of the urine or the presence of pain alone, a specialist can consider your symptoms, medical history and test findings together.
At The Kidney Health Care Clinic, patients with haematuria and other kidney-related concerns are assessed by Dr Alvin Ng, senior consultant nephrologist with more than 20 years of experience. He takes the time to explain your condition and findings, address your concerns and recommend next steps based on your individual needs.
If you are concerned about blood in your urine, schedule an appointment to discuss whether further evaluation may be appropriate.
FAQs About Seeing a Specialist for Haematuria
A nephrologist may be appropriate when the haematuria is suspected to be related to the kidneys, while a urologist evaluates conditions affecting the urinary tract, including the bladder and urethra.
Bring your previous urine and blood test results, scan reports, relevant medical records and a current list of medications and supplements. If possible, note when you first noticed the blood, how often it has occurred and any symptoms you experienced at the same time.
Yes. If blood in the urine persists or remains unexplained despite normal initial results, a specialist can review what has already been tested and decide whether further investigation or monitoring is needed.
Meet Our Doctor
Dr Alvin Ng is a senior consultant nephrologist with over two decades of experience in kidney care. Prior to setting up his own practice, Dr Ng was the Director of Peritoneal Dialysis at Changi General Hospital and executive committee member of the Singapore Society of Nephrology. He has held teaching appointments for medical students and residents and is also a recipient of various service awards, a testament to the quality of care he provides.
