Dr Alvin Ng
Senior Consultant Nephrologist
- Bachelor of Medicine and Surgery (Auckland, New Zealand)
- Fellow of the Royal Australasian College of Physicians
- Fellow of the Academy of Medicine, Singapore (Renal Medicine)
The Most Common Types of Haematuria
Haematuria primarily comes in two main forms based on how the blood is detected in the urine. These include:
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Microscopic Haematuria
Microscopic haematuria occurs when blood cells are present in the urine but are not visible to the naked eye. This type is often discovered during routine urine tests or health screenings for unrelated conditions. While microscopic haematuria may not cause immediate concern, it still warrants medical evaluation to rule out underlying problems.
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Gross Haematuria (Visible Haematuria)
Gross haematuria, also known as macroscopic haematuria, is when blood in the urine can be seen without any special equipment. The urine may appear pink, red, brown or even cola-coloured, depending on the amount of blood present. In some cases, small or large blood clots may also be visible.
What Causes Haematuria?
There are multiple potential causes of each type of haematuria. This condition is further classified according to the underlying causes linked to the presence of blood.
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Infective Haematuria
Urinary tract infections (UTIs), bladder infections (cystitis), kidney infections (pyelonephritis) and urethritis can all inflame and irritate the lining of the urinary tract, leading to bleeding. These infections often present with additional symptoms such as frequent urination, burning sensation during urination, cloudy or foul-smelling urine and sometimes fever.
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Stone-related Haematuria
Kidney or bladder stones can cause bleeding as they move through the urinary tract. The sharp edges of these stones can scratch the delicate lining of the urinary system, resulting in blood in the urine. This is often accompanied by severe pain in the back, side or lower abdomen.
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Trauma-related Haematuria
Physical injury to the kidneys, bladder or other parts of the urinary tract can cause blood in the urine. This may result from pelvic trauma, direct injury to the kidneys or the presence of foreign bodies in the urinary tract. Medical procedures involving the urinary system can also occasionally cause temporary haematuria.
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Renal Haematuria
Renal haematuria originates from the kidneys themselves. Conditions such as glomerulonephritis (inflammation of the kidney’s filtering units) and other renal disorders can lead to bleeding. This type may be accompanied by symptoms such as swelling in the hands or feet, high blood pressure and fatigue.
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Iatrogenic Haematuria
Iatrogenic haematuria refers to blood in the urine resulting from medical interventions or medications. Recent endoscopic procedures, catheterisation, kidney biopsies or the presence of ureteric stents can cause temporary bleeding. In addition, certain medications, particularly blood thinners, can increase the risk of bleeding in the urinary tract.
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Benign Haematuria
Benign causes of haematuria include non-cancerous conditions such as benign prostatic hyperplasia (BPH) in men, where an enlarged prostate gland compresses the urethra and can cause blood in the urine. Urethral strictures and certain benign kidney masses can also result in haematuria.
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Malignant Haematuria
In some cases, haematuria may indicate cancer of the bladder, kidney or prostate. While this is less common, it is one of the reasons why persistent or unexplained haematuria should always be investigated thoroughly, especially in older adults or those with risk factors like smoking.
When Should I See a Doctor for Haematuria?
Any visible blood in your urine should prompt a visit to your doctor, even if it occurs only once. Additionally, you should seek medical attention if you experience:
- Blood in the urine accompanied by pain or burning during urination
- Frequent or urgent need to urinate that is accompanied by haematuria
- Blood clots in your urine
- Persistent or recurrent haematuria
- Difficulty starting urination, weak stream or feeling of incomplete bladder emptying
- Fever, chills, nausea or vomiting accompanying haematuria
- Severe pain in your back, side or lower abdomen
Certain factors increase the importance of prompt evaluation. Older adults, particularly those over 50, should be especially vigilant about haematuria. People with a history of smoking, previous urological problems or those taking medications that affect bleeding should also seek medical attention promptly if they notice blood in their urine.
Individuals with diabetes should also be particularly cautious. Diabetes may affect kidney function and increase the risk of urinary tract infections, kidney disease and other urinary tract complications. These conditions may lead to haematuria or worsen underlying damage, making it particularly important to seek a medical evaluation if you discover blood in your urine.
Seeking Specialist Care for Haematuria
Although haematuria can sometimes be caused by temporary or minor conditions, it should never be ignored. Blood in the urine may be the first sign of an underlying issue, and identifying the cause early allows doctors to determine the severity of the condition. Timely assessment can make a major difference in treatment outcomes and resolving the source of your discomfort.
The Kidney Health Care Clinic provides comprehensive evaluation and personalised treatment for all types of kidney and urinary conditions. Led by Dr Alvin Ng Kok Heong, our senior consultant nephrologist, we utilise advanced diagnostic tools to identify the underlying cause of your haematuria and develop a tailored treatment plan to address your specific needs.
Contact us today to schedule a consultation.
Meet Our Kidney Specialist in Singapore
Dr Alvin Ng Kok Heong
Senior Consultant Nephrologist
MBChB (Auckland), FRACP (Aus), FAMS (Renal Medicine)
Dr Alvin Ng is a nephrologist and kidney specialist in Singapore with more than 20 years of experience. He specialises in managing a wide range of kidney conditions and is dedicated to providing comprehensive, personalised and evidence-based care for patients with kidney disease.
Dr Ng obtained his Bachelor of Medicine and Surgery from the University of Auckland in 2002 and completed his nephrology training in New Zealand. He was admitted as a Fellow of the Royal Australasian College of Physicians in 2010. Prior to private practice, he served as a Consultant Nephrologist at North Shore Hospital, Auckland, from 2010 before joining the Department of Renal Medicine at Changi General Hospital (CGH) in 2012.
Throughout his career in public healthcare, Dr Alvin Ng held several leadership positions within the nephrology community and received numerous awards in recognition of his service and dedication as a kidney specialist.
