Microscopic haematuria

Page Content

What is microscopic haematuria

Tab 1 Content

Microscopic haematuria is the presence of blood in the urine which cannot be detected by the naked eye, but only picked up by a urine test where the urine is studied under the microscope for red blood cells (RBCs), white blood cells (WBCs), epithelial cells (ECs) [vaginal cells] and bacteria (germs).

What causes it

Tab 2 Content

Menses
Urinary tract infection (UTI)
Kidney and/or bladder stone/s
Kidney and/or bladder tumour which may be benign or malignant (non-cancerous or cancerous).
Foreign body in the bladder, e.g., suture, tape or mesh
Radiation cystitis (radiation treatment to the bladder or pelvis)
Interstitial cystitis: a type of chronic cystitis; now known as painful bladder syndrome
Urogenital syndrome: post menopausal changes to the urinary tract and female genital organs, i.e., thinning and dryness caused by the decreased blood flow because of the very low female hormone, oestrogen, after the menopause
Pyelonephritis (inflammation of the kidneys)

What would you complain of?

Tab 3 Content

You may have no complains apart from an incidental finding of blood in the urine at your routine medical or insurance check up.
Burning urination, feeling the desperate need to pass urine very often, passing small amounts of urine and feeling that you have not voided completely (typical of urinary tract infection)
Severe sharp pain starting from usually one loin and radiating down to your groin (strongly suggestive of kidney stone passing down your ureter, the tube connecting your kidney to your bladder)
Previous radiation treatment to your bladder or pelvis for cancer (can present as radiation cystitis even years later)
Previous pelvic surgery, operation for pelvic organ prolapse or for stress incontinence of urine followed by recurrent or repeated urinary tract infection (UTI) and/or blood in the urine (should suspect a foreign body in the bladder; a rare complication)
Vaginal dryness, painful sex after the menopause (very likely to be urogenital syndrome)

What would your doctor find

Tab 4 Content

Nothing
Tenderness over your bladder and/or urethra (urine pipe) [lower tummy and/or top of your vagina]
Tenderness over your loin and groin
Vaginal dryness, thinning and pallor (paler colour)

What tests need to be done

Tab 5 Content

Urine tests to look for pus cells, red blood cells, bacteria, cancer cells
Kidney and bladder ultrasound scan
Cystoscopy: Using a medical telescope to look into your bladder and urine pipe: Typical features of Interstitial cystitis are shown in the bottom 2 photos during cystoscopy; when the bladder is drained of its filling fluid it starts to bleed like a water fall. The top 2 photos show that during initial filling the bladder is normal.

How will you treat me?

Tab 6 Content

UTI: Treat with the appropriate antibiotic.

Kidney/bladder stone /Kidney/bladder tumour / Foreign body in bladder / Radiation cystitis: For more information, please refer to the Department of Urology website.

Painful bladder syndrome [Interstitial cystitis]: Please refer to Urogynaecology clinic for cystoscopy & bladder biopsies & treatment.

Urogenital syndrome (Atrophic genitalia & bladder): Treat with topical Premarin cream & Tab Vagifem twice /week for maintenance.

Pyelonephritis: Please refer to our Renal Physician colleagues.

Tab 7 Content

Tab 8 Content

Tab 9 Content

Tab 10 Content

Tab 11 Content

Tab 12 Content

Quick Links
OneNUHS App
Getting Around NUH
Find A Doctor
Make An Appointment
Request for Bill

Careers
Events
Newsroom
Give A Gift
NUHS+ News Blog

Useful Links
Ministry of Health
Health Promotion Board
HealthHub
World Health Organisation
Agency for Integrated Care

Contact Us
Feedback
Sitemap
Terms Of Use
Personal Data Protection Act
Disclaimer
Privacy
Rate This Website

Best viewed with IE 11, Chrome 79.0, Firefox 61.0, Safari 11

2023/04/20