Haematuria means blood in the urine. It can be visible, or found only on a urine test. Most causes are benign, such as infection or stones, but it can be the first sign of bladder or kidney cancer, so it should always be investigated with a urine test, a scan and usually a cystoscopy, even if it happened once and has stopped.
Seeing blood in your urine is frightening, and the natural response is to hope it does not happen again. It often does not. That is exactly why it gets ignored, and why bladder cancer is so often found late in men. Mr Vinod Nargund investigates blood in the urine on a single fast pathway: urine tests, imaging and a look inside the bladder, usually within days, so you get an answer rather than a worry.
What causes blood in the urine?
The common causes of haematuria are urinary infection, kidney or bladder stones, an enlarged prostate, vigorous exercise and some medications. The important causes are bladder cancer, kidney cancer and, less often, prostate cancer. In men over 60 with visible blood in the urine, as many as one in five turn out to have a cancer, and it is usually curable when found at this stage.
Does it matter if it only happened once?
Yes. Bladder tumours bleed intermittently, so blood that appears once and stops is typical rather than reassuring. NHS guidance is that any man over 45 with visible blood in the urine that is not explained by a proven infection should be seen by a urologist within two weeks. Blood found only on a urine dipstick or under a microscope also needs assessing, particularly with symptoms or over the age of 60.
What tests are needed?
- Urine tests to look for infection, abnormal cells and protein.
- A scan of the kidneys and bladder. Ultrasound in many cases, or a CT scan of the urinary tract where a more detailed picture is needed.
- Flexible cystoscopy, a short examination of the inside of the bladder with a thin camera, done under local anaesthetic in a few minutes. It is the only reliable way to see the bladder lining.
- Blood tests for kidney function and, where appropriate, PSA.
Mr Nargund arranges these together, so the investigation is usually complete in one or two visits rather than spread over months.
What happens if something is found?
If the cause is an infection or a stone, treatment is straightforward and Mr Nargund manages it. If a bladder tumour is found, it is usually removed through the same camera route under a general anaesthetic, and the tissue is examined to plan any further treatment. Mr Nargund’s PhD was in bladder cancer and it has been a focus of his surgical career, so you would be treated by a consultant who has spent decades on precisely this problem.
Sources
NICE guideline NG12 on suspected cancer recognition and referral, the British Association of Urological Surgeons haematuria guidance, and NHS patient information on blood in urine.
Reviewed by Mr Vinod Nargund, MBBS, PhD, FRCS(Urol), FEBU. Last updated 12 September 2026.