Haematuria Treatment

Non-visible haematuria occurs when red blood cells are present in your urine but cannot be seen with the naked eye. Unlike visible haematuria, where urine may look pink, red, or brown, non-visible haematuria is usually identified through routine laboratory testing, such as a urine dipstick test.

Finding blood in the urine can naturally cause concern, but it does not always indicate a serious problem. Many cases are linked to treatable and straightforward issues such as urinary tract infections. However, haematuria can also be an early sign of conditions like kidney stones, kidney disease, or, less commonly, bladder or kidney cancer. For this reason, proper assessment and timely treatment are essential.

Urine tests & analysis

Urine tests play an essential role in diagnosing and managing non-visible haematuria (NVH). They help your doctor understand why blood may be present in your urine even when it cannot be seen. The process usually begins with providing a clean-catch urine sample to avoid contamination and ensure accurate results. Your sample is first tested using a dipstick, which can detect small amounts of blood as well as other substances such as protein, glucose, and ketones. A positive dipstick result does not always confirm NVH, as false positives can occur; your urine will usually be examined under a microscope to confirm the presence of red blood cells.

Urine tests can also provide helpful information about your general health. Protein in the urine may indicate kidney disease, while glucose may suggest diabetes. If signs of infection, such as raised white blood cells or nitrites, are detected, this may indicate a urinary tract infection, which is a common and treatable cause of haematuria. These findings are considered alongside your symptoms and medical history to guide any further investigation.

Your doctor will also assess your individual risk factors for more serious causes of haematuria, such as bladder cancer or kidney disease. Risk factors include being male, of an older age, having a family history of urinary tract cancers, smoking, prior exposure to certain chemicals, or previous radiotherapy. Symptoms such as pain when passing urine, tea-coloured urine, or high blood pressure may also help your doctor understand what is causing your haematuria. A physical examination, including a blood pressure check, is often carried out during your appointment.

If the cause of your non-visible haematuria remains unclear after initial tests, or if you have risk factors or ongoing symptoms, further investigation is usually advised. This may include imaging such as an ultrasound or CT scan, or referral to a specialist for a more detailed assessment.

If you are at higher risk, or if NVH is found on more than one occasion, your urine tests may be repeated over time to monitor for any changes. Ongoing surveillance helps ensure that any new or developing conditions are detected early, when treatment is often most effective.

Urine tests and analysis are therefore vital in the early detection and management of haematuria. By interpreting your results alongside your symptoms and risk factors, your healthcare team can plan the most appropriate investigations and ensure you receive timely and effective care.

Common causes of haematuria and how they are treated

Haematuria can occur for many different reasons. Your treatment will depend on the underlying cause identified during your assessment.

Urinary Tract Infections (UTIs)

Urinary tract infections are among the most common causes of blood in the urine. When the bladder or urethra becomes inflamed, small blood vessels can become irritated and leak blood into the urine. Treatment usually involves a course of antibiotics and drinking plenty of fluids. A repeat urine test is often performed afterwards to confirm that the infection has fully cleared.

Kidney stones

Kidney stones are another common reason for haematuria. Stones can rub against or block parts of the urinary tract, causing bleeding and significant discomfort. Small stones often pass naturally with hydration and pain relief, while larger stones may require shock-wave lithotripsy or minimally invasive procedures to break them up or remove them. Your doctor will typically arrange follow-up imaging to ensure the stone has passed.

Kidney disease or high blood pressure

Kidney disease and high blood pressure can also lead to microscopic haematuria. When the kidneys’ filtering system is damaged or when blood pressure is poorly controlled, red blood cells may leak into the urine. Treatment focuses on protecting kidney function through medication, dietary adjustments, blood pressure control, and regular monitoring. In some cases, your clinician may refer you to a kidney specialist for further assessment.

Bladder or kidney cancer

Bladder cancer and kidney cancer can present with haematuria, especially when the bleeding occurs without pain. If cancer is suspected, you will be referred urgently for further investigations such as imaging and cystoscopy. Treatment depends on the exact diagnosis and may involve minimally invasive surgery, radiotherapy, immunotherapy, or chemotherapy, all of which will be discussed in detail with you by a specialist team.

Enlarged prostate (Benign Prostatic Hyperplasia – BPH)

An enlarged prostate, or benign prostatic hyperplasia, is another common cause of haematuria in men. As the prostate grows, the small blood vessels within and around it can become delicate and more prone to bleeding. Treatment ranges from medications that relax or shrink the prostate to minimally invasive procedures for men with more troublesome symptoms.

Exercise-induced haematuria

Sometimes blood in the urine appears after intense physical exercise, particularly running or high-impact training. Exercise-induced haematuria is usually harmless and settles with rest and hydration. However, if bleeding persists or recurs, further assessment is essential to rule out other causes.

Medications and blood thinners

Blood-thinning medications, including aspirin, warfarin, or direct oral anticoagulants, can also contribute to haematuria. In these cases, your doctor will review your medication and make any necessary adjustments, ensuring that no underlying condition is overlooked.

Other causes

Less common causes include kidney infections, inherited conditions such as Alport syndrome, or structural abnormalities of the urinary tract. Treatment for these depends on the precise diagnosis and may involve medication, specialist referral, or further imaging to monitor your urinary system over time.