Why blood appears in the urine
Blood may come from the kidneys, ureter, bladder or urethra. Possible causes include a stone, infection, injury, prostate changes, kidney tissue disease or a tumour. Urine colour and the presence of pain cannot reliably distinguish these causes. Haematuria does not necessarily mean cancer, but serious causes must be ruled out.
A reddish colour can also be caused by food or medication. Blood from the genital tract may enter the specimen during collection. With microscopic haematuria, urine looks normal and red blood cells are detected in the laboratory; sometimes the test needs to be repeated with proper collection. Visible blood must be assessed separately — it cannot be dismissed because a later test is normal.
When care is needed now
Go to an emergency department, and call 103 or 112 if your condition worsens significantly. A routine appointment is not appropriate if:
- There are clots and you cannot urinate, with increasing pressure in the lower abdomen.
- Bleeding is accompanied by severe weakness, dizziness or fainting.
- Fever, chills and lower back pain have developed, especially if urine output has decreased noticeably.
- Blood appeared after a significant abdominal or lower back injury.
What the urologist investigates
The doctor asks when bleeding began and whether there have been clots, pain, burning, fever, operations or similar episodes in the past. Age, smoking, other illnesses and medications are relevant. If there are signs of disease in the kidney tissue itself, a nephrologist joins the assessment.
The assessment is tailored to the situation: urinalysis, kidney function assessment, ultrasound and sometimes CT urography and cystoscopy, which examines the inside of the bladder. A normal ultrasound does not rule out all causes of haematuria. If a bladder tumour is suspected, cystoscopy cannot be replaced by urinalysis or cytology alone. This does not mean everyone with occasional red blood cells needs the same set of tests.
Treatment depends on the identified cause
Stopping the bleeding and establishing a diagnosis are related but separate tasks. Infection requires infection treatment; a stone requires assessment of its location and urine drainage; a detected lesion requires a plan for further investigation and treatment. Surgery is not recommended solely because a report contains the word haematuria.
Tell your doctor about medications that affect blood clotting. Stopping them on your own is dangerous: the decision depends on why they were prescribed and the severity of bleeding. Taking these drugs does not remove the need to find the source of the blood.
Preparing for an appointment in Krasnoyarsk
Bring existing urine and blood test results, ultrasound reports, CT or MRI images with their reports, postoperative discharge summaries and a list of medications. Record the dates of episodes and accompanying symptoms. Do not delay seeking care to assemble a complete set of tests yourself.
Consultation with urologist Artem Vladimirovich Ershov: RZD Medicine, Krasnoyarsk, 47 Lomonosova Street. Call the contact centre on +7 (391) 229-22-22 to specifically request an appointment with Ershov and confirm his schedule and the consultation fee.
Before your appointment
Frequently asked questions
There was blood once, and it went away. Can I skip the tests?
No. Tell your doctor about the episode and agree on an investigation plan. Some conditions cause intermittent bleeding, including without pain.
Does cystitis explain any blood in the urine?
Not always. After an infection has been treated, the doctor checks whether the haematuria has resolved. Persistent or recurrent blood in the urine requires a reassessment of the cause.