Health Resources

Microscopic Haematuria

What is microscopic haematuria

Microscopic haematuria involves the presence of blood in urine that is not visible to the naked eye but detected through a urine test. This test looks for red blood cells (RBCs), white blood cells (WBCs), epithelial cells (ECs) and bacteria under a microscope.

What causes it
  • Menstruation
  • Urinary tract infections (UTI)
  • Kidney or bladder stones
  • Benign or malignant kidney or bladder tumours
  • Foreign bodies in the bladder, like sutures, tape or mesh
  • Radiation cystitis from bladder or pelvic radiation treatment
  • Interstitial cystitis, also known as painful bladder syndrome
  • Urogenital syndrome, postmenopausal changes in the urinary tract and genital organs
  • Pyelonephritis (kidney inflammation)
What would you complain of?
  • No symptoms, with haematuria discovered during routine medical checks.
  • Burning sensation during urination, frequent urination in small amounts, and incomplete voiding (indicative of UTI).
  • Severe pain starting from the to the groin (suggestive of kidney stones).
  • History of pelvic radiation treatment (possible radiation cystitis)
  • Recurrent UTIs or blood in urine post-pelvic surgery (possible foreign body in the bladder)
  • Vaginal dryness and painful intercourse post-menopause (likely urogenital syndrome)
What would your doctor find
  • No physical findings
  • Tenderness in the bladder or urethra area
  • Tenderness in the loin or groin
  • Vaginal dryness, thinning and paleness
What tests need to be done
  • Urine tests for pus cells, red blood cells, bacteria and cancer cells
  • Kidney and bladder ultrasound
  • Cystoscopy: A procedure using a medical telescope to inspect the bladder and urethra. Typical features of Interstitial cystitis are shown in the bottom two photos during cystoscopy; when the bladder is drained of its filling fluid it starts to bleed. The top two photos show that during initial filling the bladder is normal.


How will you treat me?

UTI: Antibiotic treatment based on the specific infection.

Kidney/bladder stones, tumours, foreign bodies, radiation cystitis: Refer to the Department of Urology website for more information.

Painful bladder syndrome (Interstitial cystitis]: Consultation at the Urogynaecology clinic for cystoscopy, bladder biopsies and treatment.

Urogenital syndrome: Treat with topical Premarin cream amd Tab Vagifem.

Pyelonephritis: Referral to our Renal Physician colleagues.

Last updated on
Best viewed with Chrome 79.0, Edge 112.0, Firefox 61.0, Safari 11
National University Health System
  • National University Hospital
  • Ng Teng Fong General Hospital
  • Alexandra Hospital
  • Jurong Community Hospital
  • National University Polyclinics
  • Jurong Medical Centre
  • National University Cancer Institute, Singapore
  • National University Heart Centre, Singapore
  • National University Centre for Oral Health, Singapore
  • NUHS Diagnostics
  • NUHS Pharmacy
  • Yong Loo Lin School of Medicine
  • Faculty of Dentistry
  • Saw Swee Hock School of Public Health
Back to Top