Managing Blood in the Urine (Hematuria):
A Guide for Patients
What is Hematuria?
Hematuria means there is blood in your urine. Sometimes you can see it (this is called visible or macroscopic hematuria), and sometimes it’s only found with a urine test (non-visible or microscopic hematuria). Both types are important and should be checked.
1. First Steps: What We Ask and Check
When you contact your GP or nurse:
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Symptoms: We’ll ask if you have pain, burning when passing urine, fever, or back pain – these could mean an infection or a kidney problem.
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Medical History: We'll talk about your general health, any previous kidney or bladder problems, and any risk factors like smoking or certain jobs.
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Medicines: Some medicines can cause blood in the urine, so we’ll check what you’re taking, including blood thinners or anti-inflammatories.
2. Tests You Might Need
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Urine Dipstick Test: A simple, quick test in the surgery to check for blood, signs of infection, or other problems.
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Lab Urine Test (Urine Culture): You’ll be asked for a midstream urine sample. This test looks for infection and helps us choose the right antibiotic if needed.
3. Blood Tests
You may need blood tests to check:
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Kidney function
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Signs of infection or inflammation
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In men over 50, we might check your PSA level (a test related to the prostate) if appropriate
4. Scans and Imaging
If your symptoms continue or there’s a concern, you may need a referral for a scan
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Ultrasound or CT scan to look at your kidneys, bladder, and tubes that carry urine.
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This helps us rule out stones, infections, or in rare cases, cancer.
5. Treating an Infection (if present)
If your urine shows signs of infection:
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You may be started on antibiotics straight away.
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We’ll adjust the treatment if the lab test shows a specific bug that needs a different antibiotic.
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For men with more serious symptoms like high fever or back pain, a stronger antibiotic may be needed.
6. What Happens Next
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Follow-Up: We ask that you repeat a sample if you have had treatment to exclude persistent blood in the urine after 2 weeks.
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Referral to a Specialist (Urology): If the cause isn’t clear, or if there’s visible blood or high risk factors (like age or smoking), we may refer you to a hospital doctor for further checks like a camera test of the bladder (cystoscopy).
Key Messages for Patients
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Blood in the urine should never be ignored, even if it goes away.
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Infections are common and often easy to treat, but we always check for other possible causes.
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Follow-up is important to make sure nothing serious is missed.