Haematuria (blood in urine): causes, tests and when to get help

Haematuria means blood in your urine (pee). The NHS says blood in your pee could come from anywhere in the urinary tract: the bladder, kidneys or urethra (the tube that carries pee out of the body).

Cancer Research UK explains that there may be blood you can see (visible) or blood that is only picked up by a urine test (not visible). The blood may not be there all the time and can come and go, and the bleeding is not usually painful.

The NHS says other symptoms might give an idea of the cause, but you should not self-diagnose. It lists these possible causes with their other symptoms. Cancer Research UK adds that blood in the urine can be caused by an infection, enlargement of the prostate or kidney stones, and that it is also the most common symptom of kidney cancer.

The NHS says blood in your pee must be checked out because it can be a sign of cancer, and that cancer may be easier to treat if it is found early. The NHS bladder cancer symptoms page says the main symptom of bladder cancer is blood in your pee, and that you should ask for an urgent GP appointment or get help from NHS 111 if you have blood in your pee even if you have no other symptoms, it is the first time, there is only a small amount or you are not sure it is blood.

Cancer Research UK says 80 out of 100 people with bladder cancer (80%) have some blood in their urine, but most people with symptoms like these do not have bladder cancer. It also lists other symptoms that are more likely from other conditions, such as passing urine very often, having a sudden need to pass urine, or pain or burning when passing urine.

The NHS says a GP will ask about your symptoms and may need to check inside your bottom (rectal examination) or your vagina. They might ask you for a pee sample or arrange a blood test, prescribe antibiotics if they think you have an infection, or refer you to a specialist for tests. You can ask for a male or female doctor and for a chaperone.

If a GP refers you to a urologist because bladder cancer is possible, the NHS says the main test is a cystoscopy, where a thin camera is passed through the urethra to see inside your bladder. It may be uncomfortable but should not be painful, and you will have painkilling medicine or it may be done under general anaesthetic. A small sample of the bladder lining may be taken for testing (a biopsy), and you may get results the same day or after a few days. A referral does not definitely mean you have cancer.

Treatment depends on the cause. A GP may prescribe antibiotics if they think you have an infection. For kidney stones, the NHS says most can be treated at home with medicine, drinking lots of water and painkillers, although they can still be painful and may take a few weeks to pass; larger stones may need a procedure or surgery to break them up or remove them.

For an enlarged prostate, the NHS says it is common and not usually serious, with treatments available if needed. If tests show cancer, a team of specialists with a clinical nurse specialist will help you through diagnosis and treatment.

The NHS says to ask for an urgent GP appointment or get help from NHS 111 if you have blood in your pee or think you may have blood in your pee. This applies even if you have no other symptoms.

For a UTI, the NHS says to also get urgent help if you have blood in your pee together with a very high or low temperature, feeling hot or cold or shivering, pain in the lower tummy or back just under the ribs, or confusion, drowsiness or difficulty speaking, where it says to call 999 or go to A&E.

The NHS says it may not be blood in your pee if you have recently eaten beetroot (this can turn pee pink), you are taking a new medicine (some medicines can turn pee red or brown), you are bleeding from your bottom instead, it is happening during your period, or you are bleeding from your vagina between periods. If you are unsure, get it checked rather than assuming.

On the NHS the first step is a GP or NHS 111, with a urine test and, if needed, referral to a urology team for tests such as cystoscopy and scans. The NHS says the GP may make an urgent referral if you have certain symptoms.

Some people use a private urologist or urology clinic to arrange tests sooner. Because blood in the urine should be investigated promptly, do not delay a first GP or NHS 111 contact while arranging private care, and ask for results to be shared with your GP.